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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. Tourette's syndrome with cervical disc herniation.

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    Lin, Jainn-Jim; Wang, Huei-Shyong; Wong, Mun-Ching; Wu, Chieh-Tsai; Lin, Kuang-Lin

    2007-03-01

    Tourette's syndrome is manifested in a broad spectrum of motor, vocal, and behavioral disturbances. Movement disorders, such as tics, may contribute to the development of cervical myelopathy owing to the effects of involuntary movements on the neck. However, the association of cervical myelopathy with motor tics of the head and neck is rare. We report here a case of a violent, repetitive neck extension due to Tourette's syndrome that developed cervical myelopathy caused by cervical disc herniation.

  3. Percutaneous cervical nucleoplasty in the treatment of cervical disc herniation.

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    Li, Jian; Yan, Deng-lu; Zhang, Zai-Heng

    2008-12-01

    Percutaneous disc decompression procedures have been performed in the past. Various percutaneous techniques such as percutaneous discectomy, laser discectomy, and nucleoplasty have been successful. Our prospective study was directly to evaluate the results of percutaneous cervical nucleoplasty (PCN) surgery for cervical disc herniation, and illustrate the effectiveness of PCN in symptomatic patients who had cervical herniated discs. From July of 2002 to June of 2005, 126 consecutive patients with contained cervical disc herniations have presented at the authors' clinic and treated by PCN. The patients' gender distribution for PCN was 65 male, 61 female. The age of patients ranged from 34 to 66 years (mean 51.9 +/- 10.2 years). The levels of involvement were 21 cases at C3-4, 30 cases at C4-5, 40 cases at C5-6, and 35 cases at C6-7. The clinical outcomes, pain reduction and the segment stability were all recorded during this study. A clinical outcome was quantified by the Macnab standard and using VAS. The angular displacement (AD) > or =11 degrees or horizontal displacement (HD) > or =3 mm was considered to be radiographically unstable. In the results of this study, puncture of the needle into the disc space was accurately performed under X-ray guidance in all cases. There was one case where the Perc-D Spine Wand had broken in the disc space during the procedure. The partial Perc-D Spine Wand, which had broken in the disc space could not be removed by the percutaneous cervical discectomy and thus remained there. There were no recurrent cases or complications in our series. Macnab standard results were excellent in 62 cases, good in 41 cases and fair in 23 cases. The rate of excellent and good was 83.73%. The VAS scores demonstrated statistically significant improvement in PCN at the 2-week, 1, 3, 6, and 12-month follow-up visits when compared to preoperational values (P PCN procedure. There was no significant difference in stability either preoperatively or

  4. 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.

  5. Cervical intradural disc herniation and cerebrospinal fluid leak

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    Ritesh Kansal

    2011-01-01

    Full Text Available Cervical intradural disc herniation (IDH is a rare condition and only 25 cases of cervical have been reported. We report a 45-year-old male who presented with sudden onset right lower limb weakness after lifting heavy weight. Magnetic resonance imaging of the cervical spine showed C5/6 disc prolapse with intradural extension. The patient underwent C5/6 discectomy through anterior cervical approach. Postoperatively, the patient improved in stiffness but developed cerebrospinal fluid leak and the leak resolved with multiple lumbar punctures.

  6. 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.

  7. 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.

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

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    Rustagi, Tarush; Badve, Siddharth; Maniar, Hemil; Parekh, Aseem N

    2011-01-01

    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.

  9. 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.

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

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    Rustagi, Tarush; Badve, Siddharth; Maniar, Hemil; Parekh, Aseem N.

    2011-01-01

    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. PMID:23259105

  11. Surgery in cervical disc herniation: anterior cervical discectomy without fusion or with fusion

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    Iencean Andrei Stefan

    2017-03-01

    Full Text Available The study included a group of anterior cervical microdiscectomy without fusion performed at one level (either C5-C6 level or at the C6-C7 level and a second group of patients with same single-level of anterior cervical discectomy with fusion. The kinematic analysis included the range of motion, anteroposterior translation and disc height assessed for the cervical functional spinal units at the operated level and adjacent levels. At the operated level the range of motion and the translation were minimal in the anterior cervical discectomy without fusion group, both for the C5-C6 and C6-C7 levels, and absent in the cervical discectomy with fusion group. The superior adjacent levels translations were greater in the ACDF group compared with the ACD group. The clinical results of both types of cervical discectomy were comparable. In cervical microdiscectomy without fusion the elastic fibrous intradiscal scar at the operated level allows a small degree of mobility and the adjacent cervical levels are not overstressed. No need for anterior cervical discectomy with fusion to trait a single level cervical disc herniation than in selected cases.

  12. 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.

  13. Cervical brucellar spondylodiscitis mimicking a cervical disc herniation with epidural abscess: a case report

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    Ahmet Aslan

    2014-05-01

    Full Text Available Brucellosis can show many clinical manifestations according to the affected sites of the body, and is usually diagnosed with osteoarticular symptoms. We present a patient with cervical brucellar spondylodiscitis and epidural abscess who presented with severe neck and left upper extremity pain and was referred to our hospital for surgery because of cervical disc herniation. The patient didn’t undergo surgery and was cured with 6 months of medical therapy. Duration of the medical therapy was assessed by magnetic resonans imaging (MRI studies. In endemic regions, brucellar spondylodiscitis should be included in differential diagnoses for patients who have cervical pain with or without neurological deficits. Patients should be attentively questioned concerning occupation, settlement place, subfebril fever, consumption of raw milk or dairy products, travel to endemic regions or past brucellosis history in the family. MRI is an important imaging modality in the diagnosis and response to medical treatment in brucellar spondylodiscitis.

  14. 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.

  15. 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.

  16. Safe physiotherapy interventions in large cervical disc herniations.

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    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.

  17. 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

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    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

  18. Cervical intervertebral disc herniation treatment via radiofrequency combined with low-dose collagenase injection into the disc interior using an anterior cervical approach.

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    Wang, Zhi-Jian; Zhu, Meng-Ye; Liu, Xiao-Jian; Zhang, Xue-Xue; Zhang, Da-Ying; Wei, Jian-Mei

    2016-06-01

    This study aimed to determine the therapeutic effect of radiofrequency combined with low-dose collagenase injected into the disc interior via an anterior cervical approach for cervical intervertebral disc herniation.Forty-three patients (26-62-year old; male/female ratio: 31/12) with cervical intervertebral disc herniation received radiofrequency combined with 60 to 100 U of collagenase, injected via an anterior cervical approach. The degree of nerve function was assessed using the current Japanese Orthopaedic Association (JOA) scoring system at 3 and 12 months postoperation. A visual analogue scale (VAS) was used to evaluate the degree of pain preoperation and 7 days postoperation. The preoperative and 3 month postoperative protrusion areas were measured and compared via magnetic resonance imaging (MRI) and picture archiving and communication systems (PACS).Compared with the preoperative pain scores, the 7-day postoperative pain was significantly reduced (P <0.01). The excellent and good rates of nerve function amelioration were 93.0% and 90.7% at 3 and 12 months postoperation, respectively, which was not significantly different. Twenty-seven cases exhibited a significantly reduced protrusion area (P <0.01) at 3 months postoperation. No serious side effects were noted.To our knowledge, this is the first study to demonstrate that the use of radiofrequency combined with low-dose collagenase injection into the disc interior via an anterior cervical approach is effective and safe for the treatment of cervical intervertebral disc herniation.

  19. 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).

  20. The clinical study of percutaneous disc decompression of treating herniation of cervical disc with Nd:YAG laser

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    Zhang, Dianxue; Cheng, Hefu; Wang, Jindong

    2005-07-01

    Objective: The possibility of PLDD (percutaneous laser disc decompression) and an ideal non-operative method which is long everlasting effect for PLDD was investigated. Methods: 159 patients of Cervical Disc Herniation with PLDD were studied. All the herniated discs were irradiated with 10­15J/S Nd:YAG laser quantum through optical-fiber under the supervision of C-arm X-ray. Results: All the patients were followed and reexamined CT or MRI after one to six months of PLDD. The result of cured (67.92%), excellent (24.53%), moderation (5.66%), non-effect (1.88%) was got. The excellent rate was 88.24%. The effective rate was 97.65%. Non-effective rate was 2.35%. Conclusion: When irradiated with Nd:YAG laser, the nucleus pulposus was vapouring, charring and coagulating. The volume and inner-pressure of the disc decreased. So the symptoms and signs improved. The main value of this methods were micro-damage, non-operation, no bleeding, no bone injury, good therapy effect, quick recovery, lesser pain, safety and excellent long everlasting effect. It is an ideal non-operative method of treating PLDD.

  1. Hemifacial hyperhidrosis associated with ipsilateral/contralateral cervical disc herniation myelopathy. Functional considerations on how compression pattern determines the laterality.

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    Iwase, Satoshi; Inukai, Yoko; Nishimura, Naoki; Sato, Maki; Sugenoya, Junichi

    2014-01-01

    Sweating is an important mechanism for ensuring constant thermoregulation, but hyperhidrosis may be disturbing. We present five cases of hemifacial hyperhidrosis as a compensatory response to an/hypohidrosis caused by cervical disc herniation. All the patients complained of hemifacial hyperhidrosis, without anisocoria or blepharoptosis. Sweat function testing and thermography confirmed hyperhidrosis of hemifacial and adjacent areas. Neck MRI showed cervical disc herniation. Three of the patients had lateral compression with welldemarcated hypohidrosis below the hyperhidrosis on the same side as the cervical lesion. The rest had paramedian compression with poorly demarcated hyperhidrosis and hypohidrosis on the contralateral side. Although MRI showed no intraspinal pathological signal intensity, lateral dural compression might influence the circulation to the sudomotor pathway, and paramedian compression might influence the ipsilateral sulcal artery, which perfuses the sympathetic descending pathway and the intermediolateral nucleus. Sweat function testing and thermography should be performed to determine the focus of the hemifacial hyperhidrosis, and the myelopathy should be investigated on both sides.

  2. Preoperative and postoperative evaluation of somatosensorial evoked potentials of upper extremities in cervical intervertebral disc herniation.

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    Umur, Ahmet Sukru; Selcuki, Mehmet; Selcuki, Deniz; Temiz, Cuneyt; Akbasak, Aytac

    2013-01-01

    This study aims to determine the dysfunction caused by existing pathological condition in structures involved in the transfer of sensory functions of the neural system in cervical disc herniation, and to establish whether or not the level and degree of this anatomical damage can be anticipated by SEP (Somatosensorial Evoked Potentials). We compared the obtained SEP values for statistical significance using the Friedman Variation Analysis. In parameters with statistical significance, the Wilcoxon Signed Rank test was used to identify when significant improvements occurred. The study found that the statistical data of the latency of the N14 wave originating from the dorsal column nuclei of the medulla spinalis and dorsal column gray matter improved (p < 0.05) in the postoperative period compared with the preoperative values. Using the Wilcoxon Signed Rank test, we studied postoperative months separately in regard to the difference in the latency of the N14 wave, and found the statistically significant improvement to be marked particularly in months 3 and 6 postoperatively (p < 0.05). In conclusion, we suggest that SEP is a useful tool to check the functional condition of the dorsal spinal column. The benefit of the SEP utilization is the ability to determine the severity of the pathological condition preoperatively and follow the patient's functional postoperative improvement.

  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. Clinical and magnetic resonance imaging features of compressive cervical myelopathy with traumatic intervertebral disc herniation in cynomolgus macaque (Macaca fascicularis)

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    Choi, Yun-Jung; Park, Hye-Jin; Sohn, Chul-Ho; Jung, Kyeong Cheon; Park, Seong Hoe

    2016-01-01

    Intervertebral disc herniation (IVDH) with nucleus pulposus extrusion, traumatic or not, is a devastating clinical condition accompanied by neurological problems. Here we report a cynomolgus macaque suffering from acute and progressive neurological dysfunction by a blunt trauma due to neck collar, an animal handling device. Tetraplegia, urinary incontinence, decreased proprioception, and imperception of pain were shown on physical and neurological examinations. MRI sagittal T2 weighted sequences revealed an extensive protrusion of disc material between C2 and C3 cervical vertebra, and this protrusion resulted in central stenosis of the spinal cord. Histopathologic findings showed a large number of inflammatory cells infiltrated at sites of spinal cord injury (SCI). This case is the first report of compressive cervical SCI caused by IVDH associated with blunt trauma. PMID:28053621

  5. 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

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    van den Akker Elske

    2010-06-01

    Full Text Available Abstract Background 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 a known entity on the long term. Recently, cervical disc prostheses are developed to maintain motion and possibly reduce the incidence of adjacent disc degeneration. A comparative cost-effectiveness study focused on adjacent segment degeneration and functional outcome has not been performed yet. We present the design of the NECK trial, a randomised study on cost-effectiveness of anterior cervical discectomy with or without interbody fusion and arthroplasty in patients with cervical disc herniation. Methods/Design Patients (age 18-65 years presenting with radicular signs due to single level cervical disc herniation lasting more than 8 weeks are included. Patients will be randomised into 3 groups: anterior discectomy only, anterior discectomy with interbody fusion, and anterior discectomy with disc prosthesis. The primary outcome measure is symptomatic adjacent disc degeneration at 2 and 5 years after surgery. Other outcome parameters will be the Neck Disability Index, perceived recovery, arm and neck pain, complications, re-operations, quality of life, job satisfaction, anxiety and depression assessment, medical consumption, absenteeism, and costs. The study is a randomised prospective multicenter trial, in which 3 surgical techniques are compared in a parallel group design. Patients and research nurses will be kept blinded of the allocated treatment for 2 years. The follow-up period is 5 years. Discussion Currently, anterior cervical discectomy with fusion is the golden standard in the surgical treatment of cervical disc herniation. Whether additional interbody fusion or disc prothesis is necessary and cost-effective will be determined by this trial

  6. Fluoroscopic cervical epidural injections in chronic axial or disc-related neck pain without disc herniation, facet joint pain, or radiculitis

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    Manchikanti L

    2012-07-01

    Full Text Available Laxmaiah Manchikanti, Kimberly A Cash, Vidyasagar Pampati, Yogesh MallaPain Management Center of Paducah, Paducah, KY, USABackground: While chronic neck pain is a common problem in the adult population, with a typical 12-month prevalence of 30%–50%, there is a lack of consensus regarding its causes and treatment. Despite limited evidence, cervical epidural injections are one of the commonly performed nonsurgical interventions in the management of chronic neck pain.Methods: A randomized, double-blind, active, controlled trial was conducted to evaluate the effectiveness of cervical interlaminar epidural injections of local anesthetic with or without steroids for the management of chronic neck pain with or without upper extremity pain in patients without disc herniation, radiculitis, or facet joint pain.Results: One hundred and twenty patients without disc herniation or radiculitis and negative for facet joint pain by means of controlled diagnostic medial branch blocks were randomly assigned to one of two treatment groups, ie, injection of local anesthetic only (group 1 or local anesthetic mixed with nonparticulate betamethasone (group 2. The primary outcome of significant pain relief and improvement in functional status (≥50% was demonstrated in 72% of group 1 and 68% of group 2. The overall average number of procedures per year was 3.6 in both groups with an average total relief per year of 37–39 weeks in the successful group over a period of 52 weeks.Conclusion: Cervical interlaminar epidural injections of local anesthetic with or without steroids may be effective in patients with chronic function-limiting discogenic or axial pain.Keywords: chronic neck pain, cervical disc herniation, cervical discogenic pain, cervical epidural injections, epidural steroids, local anesthetics

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

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    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.

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

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    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.

  9. Coexistence of Miyofascial Trigger Points and Cervical Disc Herniation: Which One is the Main Source of Pain?

    Directory of Open Access Journals (Sweden)

    Gülcan Öztürk

    2016-04-01

    Full Text Available Objective: The aim of this study was to investigate the coexistence of myofascial trigger points (MTrPs and cervical disc herniations (CDH in patients with neck and upper back pain. Materials and Methods: In this retrospective study, patients having only MTrPs were defined as group-1, patients having only CDH were defined as group-2, patients having both MTrPs and CDH were defined as Group-3. Two hundred twenty three patients (151 females/72 males; mean age 38.2±10.1 years were enrolled in this study. There were 30 patients in group 1, 46 patients in group 2, 147 patients in group 3. Results: Thirty eight patients had radiculopathy, 27 of them had MTrP(s. There was no significant difference in terms of CDH level (p=0.275 and degree of herniation (p=0.188 between groups 2 and 3. There was no significant difference in terms of MTrP localisation (p=0.684 between groups 1 and 3. There was no significant difference in terms of MTrP localisations according to CDH level and nerve root compression level in groups 3. Conclusion: MTrP and CDH coexistence is frequent. Management of the pain in the upper back region should be based on whether if the pain originates from MTrP, CDH or both

  10. 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.

  11. Evaluation of intervertebral disc herniation and hypermobile intersegmental instability in symptomatic adult patients undergoing recumbent and upright MRI of the cervical or lumbosacral spines

    Energy Technology Data Exchange (ETDEWEB)

    Ferreiro Perez, Antonio [Hospital De Madrid, Department of Radiology, Plaza Del Conde Del Valle De Suchil, 28015 Madrid (Spain)]. E-mail: antoine69@terra.es; Garcia Isidro, Millan [Hospital De Madrid, Department of Radiology, Plaza Del Conde Del Valle De Suchil, 28015 Madrid (Spain); Ayerbe, Elena [Hospital De Madrid, Department of Radiology, Plaza Del Conde Del Valle De Suchil, 28015 Madrid (Spain); Castedo, Julio [Hospital De Madrid, Department of Radiology, Plaza Del Conde Del Valle De Suchil, 28015 Madrid (Spain); Jinkins, J.R. [Hospital De Madrid, Department of Radiology, Plaza Del Conde Del Valle De Suchil, 28015 Madrid (Spain)

    2007-06-15

    Purpose: The purpose of the study was to determine the difference in findings between recumbent and upright-sitting MRI of the cervical and lumbosacral spine in patients with related sign and symptoms. Materials and methods: A total of 89 patients were studied (lumbosacral spine: 45 patients; cervical: 44 patients). T1-weighted (TR: 350, TE: 20) fast spin echo and T2-weighted (TR: 2500, TE: 160) fast spin echo images were acquired in the sagittal and axial planes in both the recumbent and sitting-neutral positions. The images were acquired on the Upright{sup TM} MRI unit (Fonar Corporation, Melville, NY). Differences were sought between the recumbent and upright-sitting positions at all levels imaged, in both planes. Results: The total number of cases of pathology was 68, including instances of posterior disc herniation and anterior and posterior spondylolisthesis. Focal posterior disc herniations were noted in 55 patients (cervical: 31, lumbosacral: 24) [62% of patients]. Six of these herniations (cervical: 4, lumbosacral: 2) [11%] were seen only on the upright-sitting study. Focal posterior disc herniations were seen to comparatively enlarge in size in 35 patients on the upright-seated examination (cervical: 21, lumbosacral: 14) [72%], and reduce in size in 9 patients (cervical: 5, lumbosacral: 4) [18%]. Degenerative anterior (n: 11) and posterior (n: 2) spondylolisthesis was seen in 13 patients (cervical: 0, lumbosacral: 13) [15% of patient total]. Anterior spondylolisthesis was only seen on the upright-seated examination in 4 patients (cervical: 0, lumbosacral: 4) [31%]. Anterior spondylolisthesis was comparatively greater in degree on the upright-seated study in 7 patients (cervical: 0, lumbosacral: 7) [54%]. Posterior spondylolisthesis was comparatively greater in degree on the recumbent examination in 2 patients (cervical: 0, lumbosacral: 2) [15%]. The overall combined recumbent miss rate in cases of pathology was 15% (10/68). The overall combined recumbent

  12. 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.

  13. Natural course of lumber disc herniation

    Energy Technology Data Exchange (ETDEWEB)

    Tokioka, Takamitsu; Shimada, Kimio; Tanaka, Yuzo; Oshige, Toshihisa; Miyakoshi, Koichi [Okayama Rosai Hospital (Japan)

    1998-09-01

    Thirty-two cases of lumbar disc herniation were sequentially followed by MR imagings in order to ascertain its natural course. Herniation consisted of protrusion in 6 cases, extrusion in 13 cases, and sequestration in 13 cases. We analysed the durations until the herniation regressed more than 50% of its A-P diameter. The mean duration was 8.2 months for extrusion, and 5.3 months for sequestration. Only 2 cases of protrusion regressed within 12 months. Huge disc herniations with central protrusion in particular showed slight spontaneous regression. (author)

  14. 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 ...

  15. 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.

  16. Spontaneous resorption of a large cervical herniated nucleus pulposus.

    Science.gov (United States)

    Cvetanovich, Gregory L; Hsu, Andrew R; Frank, Rachel M; An, Howard S; Andersson, Gunnar B

    2014-07-01

    The majority of patients with symptomatic herniated discs can be successfully and conservatively managed and can achieve clinical improvement without surgical intervention. Resorption of the herniated nucleus pulposus (HNP) is 1 conservative mechanism for clinical improvement. We present the case of a 76-year-old healthy man with acute cervical radicular right arm pain and positive Spurling test. Magnetic resonance imaging (MRI) showed a large disc extrusion behind the C6 vertebral body, causing severe central canal stenosis and right-greater-than-left foraminal stenosis. The patient did not want surgical intervention, and his symptoms resolved with conservative treatment. A follow-up MRI 7 months after his initial presentation showed almost complete resorption of the herniated disc. The patient returned to his normal activities and has not had recurrence of symptoms for 2 years. This report provides an interesting example of complete resorption of a large, extruded cervical herniated disc in a symptomatic patient and a review of the literature on resorption of herniated discs. The review suggests that larger herniations with an epidural location (penetration of the posterior longitudinal ligament) have a greater chance of resorption.

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

    Science.gov (United States)

    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 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.

  18. Effect of continuous lumbar traction on the size of herniated disc material in lumbar disc herniation.

    Science.gov (United States)

    Ozturk, Bulent; Gunduz, Osman Hakan; Ozoran, Kursat; Bostanoglu, Sevinc

    2006-05-01

    We investigated the effects of continuous lumbar traction in patients with lumbar disc herniation on clinical findings, and size of the herniated disc measured by computed tomography (CT). In this prospective, randomized, controlled study, 46 patients with lumbar disc herniation were included, and randomized into two groups as the traction group (24 patients), and the control group (22 patients). The traction group was given a physical therapy program and continuous lumbar traction. The control group was given the same physical therapy program without traction, for the same duration of time. Data for the clinical symptoms and signs were collected before and after the treatment together with calculation of a herniation index, from the CT images that showed the size of the herniated disc material. In the traction group, most of the clinical findings significantly improved with treatment. Size of the herniated disc material in CT decreased significantly only in the traction group. In the traction group the herniation index decreased from 276.6+/-129.6 to 212.5+/-84.3 with treatment (p0.05). Patients with greater herniations tended to respond better to traction. In conclusion, lumbar traction is both effective in improving symptoms and clinical findings in patients with lumbar disc herniation and also in decreasing the size of the herniated disc material as measured by CT.

  19. 中青年颈椎间盘突出症的CT对照分析%CT Analysis of Young and Middle-aged Cervical Disc Herniation

    Institute of Scientific and Technical Information of China (English)

    宋樟伟; 葛文; 许崇永; 陈雪鹏; 吴爱琴; 高凌云

    2011-01-01

    159 joints with the degree of protrusion of 2.13 ± 0.11mm , vertebral canal stenosis was 1.3% ( 2/159) , hypertrophy of ligament falvum was 8.2%( 13/159) , centrum and intervertebral facet joints hyperplasia waa 35.2% ( 56/1 59 ) .All parameters , except for centnun and intervertebral facet joints hyperplasia in two groups, had significant statistics difference( P < 0.05 ) .Conclusion The relevance ratio of protrusion of intervertehral disc, the degree of protrusion, vertebral canal stenosis and hypertrophy of ligament falvum, in symptomatic group were less distinct than those in asymptomatic group.The possibility to develop into cervical spondylosis, which needed early treatment, was greater if cervical disc herniation had reached above 3.6mm or had association with vertebral canal stenosis or hypertrophy of ligament falvum.CT may find cervical disC herniation and the degree of protrusion in the early stage, which is an important checking method of cervical disc herniation.

  20. 动力位MRI对颈椎椎间盘突出症的诊断价值%The value of kinematic magnetic resonance imaging in diagnosis of cervical disc herniation

    Institute of Scientific and Technical Information of China (English)

    劳立峰; 钟贵彬; 李新锋; 刘祖德

    2013-01-01

    目的:评估过屈位和过伸位核MRI对颈椎椎间盘突出症的诊断价值。方法对50例患者进行中立位、过屈位和过伸位颈椎MRI检查。利用计算机软件对各个节段颈椎间盘突出程度进行客观测量评估。结果在过伸位上,各节段颈椎椎间盘突出同中立位相比均有显著性增加(t=2.05~5.05,P<0.05)。在中立位正常或椎间盘突出<3 mm,2.21%患者在过屈位椎间盘突出进展到>3 mm,16.54%患者在过伸位椎间盘突出进展到>3 mm。在中立位椎间盘突出>3 mm且<5 mm,3.57%患者在过屈位椎间盘突出进展到>5 mm,10.71%患者在过伸位椎间盘突出进展到>5 mm。结论与中立位相比,动力位 MRI 上颈椎椎间盘突出更加明显。动力位MRI对颈椎间盘突出症的评估有其独特价值,尤其是对那些有神经根症状而普通MRI无异常发现的患者。%Objective To determine if adding flexion and extension MRI studies to the traditional neutral views would be beneficial in the diagnosis of cervical disc herniations. Methods Fifty patients underwent MRI in neutral, flexional and extensional positions. The images were analyzed using computer software to objectively quantify the amount of disc herniation. Results Compared to neutral position, cervical disc herniations were significantly increased in extension MRI (P<0.05). For patients with normal or 3 mm of disc bulge in neutral, 2.21%demonstrated an increase in herniation to 3 mm bulge in flexion, and 16.54%demonstrated an increase to 3 mm bulge in extension. For patients in the neutral view that had a baseline disc bulge of 3 to 5 mm, 3.57%had increased herniations to 5mm in flexion and 10.71%had increased herniations to 5 mm in extension. Conclusion A significant increase in the degree of cervical disc herniation is found by examining flexion and extension views when compared with neutral views alone. Kinematic MRI views provide valuable added information

  1. Cervical Total Disc Arthroplasty

    OpenAIRE

    Basho, Rahul; Hood, Kenneth A.

    2012-01-01

    Symptomatic adjacent segment degeneration of the cervical spine remains problematic for patients and surgeons alike. Despite advances in surgical techniques and instrumentation, the solution remains elusive. Spurred by the success of total joint arthroplasty in hips and knees, surgeons and industry have turned to motion preservation devices in the cervical spine. By preserving motion at the diseased level, the hope is that adjacent segment degeneration can be prevented. Multiple cervical disc...

  2. 颈椎前路减压人工颈椎间盘置换术与融合术治疗单节段颈椎间盘突出症的短期疗效比较%Clinical outcome of Discover artificial cervical disc replacement versus anterior cervical decompression and fusion for single segment cervical disc herniation

    Institute of Scientific and Technical Information of China (English)

    卡哈尔·艾肯木; 楚戈; 王振斌; 陈继征; 顾文飞; 胡雅斌; 涂来勇; 赵疆; 项泽文

    2014-01-01

    Background: The curative effect of anterior cervical discectomy and fusion (ACDF) is satisfactory for the patients with symptomatic cervical disc herniation. However, it can result in stress increase in adjacent segments and speed up the degen-eration of adjacent segments. Artificial cervical disc replacement (ACDR), a typical non-fusion surgical treatment, may be an alternative to ACDF for cervical disc herniation. Objective:To compare the clinical outcomes between ACDR and ACDF for single segmental cervical disc herniation. Methods:From January 2009 to February 2012, 61 patients with single segmental cervical disc herniation were treated in our hospital. Of them, 26 received Discover ACDF (arthroplasty group) and 35 underwent single-level ACDF (fusion group). Visual analogue scale (VAS) neck/arm pain score, Japanese Orthopedics Association (JOA) score and flexion-exten-sion range of motion of operative and adjacent segments were evaluated preoperatively and 1 week and 3, 6, 12, and 24 months postoperatively. Complications and secondary treatment were recorded. Results:A total of 52 patients (29 in arthroplasty group and 23 in fusion group) were followed up. The average follow-up pe-riod was 15.3 months (range, 12-24 months). The VAS scores of neck pain and upper limb pain and JOA score were signifi-cantly improved during follow up as compared with preoperative ones in all patients (P0.05). In arthroplasty group, there was no significant difference in range of motion of opera-tive and adjacent segments before and after treatment (P>0.05). The rate of fusion achievement was 90.5%. In arthroplasy group, prosthesis antedisplacement (<3 mm) in 2 patients at 6 months after surgery, and cerebrospinal fluid leakage oc-curred 1 patient. In fusion group, adjacent segment disease occurred in one patient who underwent secondary operation. Conclusions:Discover cervical disc replacement is a feasible alternative to ACDF for patients with persistent symptomatic cervical disc

  3. Lumbar herniated disc: spontaneous regression

    Science.gov (United States)

    Yüksel, Kasım Zafer

    2017-01-01

    Background Low back pain is a frequent condition that results in substantial disability and causes admission of patients to neurosurgery clinics. To evaluate and present the therapeutic outcomes in lumbar disc hernia (LDH) patients treated by means of a conservative approach, consisting of bed rest and medical therapy. Methods This retrospective cohort was carried out in the neurosurgery departments of hospitals in Kahramanmaraş city and 23 patients diagnosed with LDH at the levels of L3−L4, L4−L5 or L5−S1 were enrolled. Results The average age was 38.4 ± 8.0 and the chief complaint was low back pain and sciatica radiating to one or both lower extremities. Conservative treatment was administered. Neurological examination findings, durations of treatment and intervals until symptomatic recovery were recorded. Laségue tests and neurosensory examination revealed that mild neurological deficits existed in 16 of our patients. Previously, 5 patients had received physiotherapy and 7 patients had been on medical treatment. The number of patients with LDH at the level of L3−L4, L4−L5, and L5−S1 were 1, 13, and 9, respectively. All patients reported that they had benefit from medical treatment and bed rest, and radiologic improvement was observed simultaneously on MRI scans. The average duration until symptomatic recovery and/or regression of LDH symptoms was 13.6 ± 5.4 months (range: 5−22). Conclusions It should be kept in mind that lumbar disc hernias could regress with medical treatment and rest without surgery, and there should be an awareness that these patients could recover radiologically. This condition must be taken into account during decision making for surgical intervention in LDH patients devoid of indications for emergent surgery. PMID:28119770

  4. 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.

  5. 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.

  6. 颈椎动态稳定器治疗颈椎间盘突出症的早期临床疗效%Early clinical effects of dynamic cervical implant in treatment of cervical disc herniation

    Institute of Scientific and Technical Information of China (English)

    高延征; 司文腾; 余正红; 高坤; 陈书连; 张广泉

    2012-01-01

    目的 探讨应用颈椎动态稳定器(dynamic cervical implant,DCI)治疗颈椎间盘突出症的安全性及早期临床疗效.方法 2009年9月至2010年12月,应用颈前路DCI治疗31例颈椎间盘突出症患者,记录并统计分析手术时间和出血量;采用颈椎残障功能指数(neck disability index,NDI)、日本矫形外科协会(Japanese Orthopaedic Association,JOA)评分评价神经功能改善情况,评估患者手术前后的疼痛视觉模拟评分(visual analogue scale,VAS).在X线片上测量术前和末次随访时植入节段的运动范围、手术节段脊柱功能单位(functional spine unit,FSU)高度与上位椎体高度比值(H/h)等的差异.结果 31例患者的手术时间为(45±15) min,出血量为(100±30) ml.术后随访6~20个月,平均14个月.术前与末次随访时植入节段的运动范围(9.6°±4.2°vs.6.9°±5.3°,P>0.05)、H/h(2.6±0.1 vs.2.5±0.1,P>0.05)和FSU的角度(2.6°±5.2°vs.1.7°±2.9°,P>0.05)差异无统计学意义;而术前与末次随访时NDI(50.5±16.2vs.19.6±4.3,P< 0.05)、JOA评分(12.3±1.6 vs.13.9±1.8,P< 0.05)及颈痛VAS(6.3±2.6 vs.3.1±2.2,P<0.05)差异有统计学意义.结论 应用DCI非融合技术治疗颈椎间盘突出症,手术时间短,出血少,可以早期保留手术节段的运动功能,维持了椎间高度,早期临床效果满意.%Objective To investigate the safety and early clinical efficiency of dynamic cervical implant (DCI) internal fixation to treat cervical disc herniation.Methods From September 2009 to December 2010,31 patients with herniation of cervical disc underwent DCI implantation.The operation time and blood loss were recorded and analyzed.Neck disability index (NDI),Japanese Orthopaedic Association (JOA) score,and visual analogue scale (VAS) score were used to evaluate neurofunctional recovery pre- and post-operation.Routinely,the patients accepted X-ray examination preoperatively and postoperatively.We used White's measurement to

  7. Diagnostic accuracy of magnetic resonance imaging of lumbar disc herniation

    Energy Technology Data Exchange (ETDEWEB)

    Ikeda, Takashi; Nakamura, Takafumi; Kikuchi, Taro; Watanabe, Hiroyuki; Takagi, Katsumasa; Yoshizumi, Kazuhiro; Katahira, Kazuhiro [Kumamoto Univ. (Japan). School of Medicine

    2000-03-01

    We studied the accuracy of MRI in lumbar disc herniation, comparing the results with the operative findings in the assessment of the rupture of the posterior longitudinal ligament (PLL), and type of herniation. The MRI findings in 47 subjects who were operated on for lumbar disc herniation were retrospectively studied. The accuracy rate was 75.2% for the rupture of the PLL and 40.4% for the type of herniation respectively. It was hard to differentiate subligamentous extrusion from transligamentous extrusion on MRI. (author)

  8. 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 .

  9. A Symptomatic Spinal Extradural Arachnoid Cyst with Lumbar Disc Herniation

    Directory of Open Access Journals (Sweden)

    Yoshinori Kadono

    2015-01-01

    Full Text Available Spinal epidural arachnoid cyst (EAC is a rare, usually asymptomatic condition of unknown origin, which typically involves the lower thoracic spine. We report a case of posttraumatic symptomatic EAC with lumbar disc herniation. A 22-year-old man experienced back pain and sciatica after a traffic accident. Neurological examination revealed a right L5 radiculopathy. Magnetic resonance imaging demonstrated a cystic lesion at the L3 to L5 level and an L4-5 disc herniation; computed tomography myelography showed that the right L5 root was sandwiched between the cyst and the herniation. A dural defect was identified during surgery. The cyst was excised completely and the defect was repaired. A herniation was excised beside the dural sac. Histology showed that the cyst wall consisted of collagen and meningothelial cells. Postoperatively the symptoms resolved. Lumbar spinal EACs are rare; such cysts may arise from a congenital dural crack and grow gradually. The 6 cases of symptomatic lumbar EAC reported in the literature were not associated with disc herniation or trauma. In this case, the comorbid disc herniation was involved in symptom progression. Although many EACs are asymptomatic, comorbid spinal disorders such as disc herniation or trauma can result in symptom progression.

  10. 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.

  11. Endoscopic anterior decompression in cervical disc disease

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    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. MRI Analysis of the Structural Morphology of Cervical Intervertebral Disc Herniation%颈椎间盘突出症牵引下MRI影象学的形态结构分析

    Institute of Scientific and Technical Information of China (English)

    宋洪臣; 赵国库; 刘世文; 安晓芳

    2001-01-01

    目的对18例患者总计突出颈椎间盘28个,比较不同牵引方向对颈椎间盘突出症(HCD)的颈椎功能变化规律。方法借助MRI影象扫描研究不同牵引方向对颈椎突出间盘的运动、脊髓受压指数、椎间隙的变化及伴有变性病例的作用。结果不同的牵引方向对间盘突出的作用是有差异的,屈曲牵引使间盘部分还纳最为明显。脊髓受压指数在屈曲方向牵引最低。伸展牵引时椎间盘突出缩小组的后缘椎间隙减小明显。屈曲牵引时椎间盘缩小组与无变化组的后缘变化差异不大,两种牵引方向对前缘影响均无差异。各种方向牵引伴有变性者的形态变化不明显。结论 HCD改变了正常椎关节的微细形态结构,对常规牵引方向的规律宜灵活运用。脊髓受压指数比间盘突出大小更能反映脊髓受损的实质。牵引对伴有变性者意义可能不大。%Objective To compare the fuctional and morphological changes of the cervical spine of 18 patients (28 disci herniations) under different directions in herniation of cervical disc (HCD).Methods To study the effect of different directions of traction on the movement of herniated disc,compression index of spinal cord,changes of intervertebral space and the influence on cases with degeneration by MRI.Results There were differences among the effects of traction in different directions.Most significant partial retraction of the herniated disc was experienced in flexion traction.Both flexion and extension traction caused marked reduction of index of compression of spinal cord.Extension traction resulted in marked narrowing of the posterior edge of intervertebral space in the group with disc size reduction,but there was not much difference between the groups with and without disc size reduction under flexion traction.There was no marked effect on the morphological changes in cases with degeneration in any direction of

  13. 经皮穿刺手动调压脉冲射频模式治疗颈椎间盘突出症%THE CLINICAL EFFECTS OF PERCUTANEOUS PUNCTURE MANUAL VOLTAGE REGULATION PULSED RADIOFREQUENCY MODE ON CERVICAL DISC HERNIATION

    Institute of Scientific and Technical Information of China (English)

    吴大胜; 刘娜; 宫小文; 宋永光

    2012-01-01

    Objective: To evaluate the clinical effects of percutaneous puncture manual voltage regulation pulsed radiofrequency mode on the treatment cervical disc herniation. Methods: From August 2010 to September 2011, 112 patients with cervical disc herniation were given with percutaneous puncture manual voltage regulation pulsed radiofrequency mode guided through C arm X-ray machine, CT or DSA. The visual analogue scale (VAS) score and clinical effects were recorded before and after treatment. Results: After 3 d the treatment, the excellent cases were 96, the good cases were 14, and the bad cases were 2, the excellent and good rate was 98.2%. There were 2 bad cases because the doctor failed to grasp the good indication. Compared with pre-operation (7.8 ± 0.4), the VAS at 3 d after operation (1.5 ± 0.3) was decreased (P < 0.05). Conclusion: Percutaneous puncture manual voltage regulation pulsed radiofrequency mode therapy is a suitable treatment for cervical disc herniation, with the advantages of simple operation, easy to master, small trauma, not influencing the stability of spine biomechanics, no serious complications.%目的:评估手动调压脉冲射频模式治疗颈椎间盘突出症的临床可行性.方法:2010年8月~2011年9月,112例颈椎间盘突出症患者,在C型臂X线机、CT或DSA引导下接受经皮穿刺手动调压脉冲射频模式治疗.观察并记录术前后的视觉模拟评分(visual analogue scale,VAS),并进行疗效评估.结果:本组112例患者,经过该技术治疗后3d,其中96例治疗效果达优级,14例治疗效果良好,2例效果差,优良率98.2%.其中,效果较差的2例是因为未把握好适应症.与术前VAS评分(7.8±0.4)相比,术后3天VAS评分(1.5±0.3)降低(P<0.05).结论:经皮穿刺手动调压脉冲射频模式治疗颈椎间盘突出症具有操作简单、易于掌握、创伤小、不影响脊柱生物力学稳定性、无严重并发症等特点.是一种可供临床选用的、效果确切又较

  14. NURSING FOR PATIENTS RECEIVING OZONE NUCLEOPLASTY IN TREATING CERVICAL DISC HERNIATION%三氧髓核消融术治疗颈椎间盘突出的临床护理

    Institute of Scientific and Technical Information of China (English)

    赵莉华

    2016-01-01

    Objective To explore the nursing for patients receiving ozone nucleoplasty in treating cervical disc herniation .Methods 60 cases of cervical disc herni‐ation received ozone nucleoplasty and careful periopera‐tive clinical care .Results No complications occurred ,and the 3‐12 months of follow‐up surveys found that the total effective rate was 97% .Conclusion Full preoperative preparation ,intra‐operative coordination and postoperative rehabilitation as well as mental care can produce good effect on operation .%目的:探讨颈椎间盘突出患者三氧髓核消融术治疗的临床护理效果。方法对60例颈椎间盘突出患者在C臂可视导向下,将不同浓度的高科技医用三氧消融剂用专业注射针注射到病变突出处,使髓核体积缩小回纳到纤维环里面,并给予精心的围手术期护理。结果无一例并发症发生,随访3~12个月,总有效率达97%。结论做好术前准备,术中配合,术后康复训练及心理护理,对手术成功有重要意义。

  15. A radiological study on lumbar disc herniation in Korean

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    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.

  16. [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.

  17. [Clinical manifestation and surgical treatment of superior lumbar disc herniation].

    Science.gov (United States)

    Klishin, D N; Dreval', O N; Gorozhanin, A V

    2011-01-01

    On the basis of analysis of presentation and surgical treatment of 103 patients with lumbar disc herniation the authors performed comparative assessment of symptoms and therapeutic techniques in patients with higher and lower lumbar disc disease. Short-term and long-term results were evaluated using visual analogue scale and Oswestry disability index (ODI). Statistically significant differences in dynamics of pain and ODI were not present. In spite of differences in clinical presentation, the results of surgical treatment in both groups were similar. They depended on severity of preoperative neurological deficit regardless of level of lesion. Specific features of surgical procedure in superior lumbar disk herniation are described.

  18. Herniation of the cervical disk in plastic surgeons.

    Science.gov (United States)

    Tzeng, Yuan-Sheng; Chen, Shyi-Gen; Chen, Tim-Mo

    2012-12-01

    Herniations of the cervical disk in plastic surgeons are far more common in practice than the paucity of reported cases would indicate. A likely explanation may be the peculiar, nonergonomic positions that plastic surgeons must hold during surgery while wearing a headlight and loupes. From January 2003 to December 2006, at Tri-Service General Hospital, Taiwan, 4 plastic surgeons experienced herniations of the cervical disk. Magnetic resonance imaging study indicated there was disk herniation or bulging with spinal cord impingement. Two plastic surgeons received cervical diskectomy, corpectomy with strut reconstruction using titanium cages. These 2 surgeons were symptom-free 2 years after their operations. The other 2 plastic surgeons were under conservative physical therapy with persistent symptoms. The clinical evidence indicated that cervical disk herniation is an occupational hazard in plastic surgeons. To prevent prolonged hyperflexion and twisting of the neck, we proposed wearing a cervical brace during surgery for the plastic surgeons at Tri-Service-General Hospital since January 2008. No more plastic surgeons have experienced herniation of the cervical disk since then. The results indicated that wearing a cervical brace may be an effective measure to protect plastic surgeons from cervical disk disease.

  19. 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.

  20. Upper Lumbar Disc Herniation Presenting as Acute Abdomen

    Directory of Open Access Journals (Sweden)

    Borghei- Razavi Hamid

    2009-10-01

    Full Text Available A woman presenting with severe right lower quadrant (RLQ abdominal pain is presented here. She was evaluated for all usual cause of such pain. Laboratory tests and abdominal and pelvic sonography was normal. MRI revealed L1-L2 disc herniation.

  1. Rehabilitation nursing of 37 patients with dynamic cervical implant for the treatment of cervical disc herniation%37例颈椎间盘突出症患者行颈椎动态稳定器治疗的康复护理

    Institute of Scientific and Technical Information of China (English)

    张俊娟; 王俊杰; 范丽娟; 田慧; 高坤; 翟艺恒

    2012-01-01

    This paper summarizes the rehabilitation nursing of 37 patients with dynamic cervical implant(DCI) for the treatment of cervical disc herniation. Perioperative sternocleidomastoid and trapezius muscles isometric contraction exercises could enhance the neck or back muscle strength, maintain cervical stability, restore and enhance the range of motion of the cervical spine. The patients could participate in early training without neck collars. The JOA score increased significantly at 14 months after operation and the cervical rigid sense was lower than traditional fusion surgery.%总结了37例颈椎动态稳定器治疗颈椎间盘突出症患者围手术期的康复护理.认为围手期胸锁乳突肌和斜方肌的等长等张收缩训练可增强颈背部肌肉力量,保持颈椎的稳定性,恢复及增进颈椎的活动范围.本组患者术后不用佩戴颈托即可早期训练,平均随访14个月,根据日本骨科学会评分标准,本组改善率均为优良,颈椎僵硬感较传统融合手术轻.

  2. Lumbar disc herniation at high levels : MRI and clinical findings

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    Paek, Chung Ho; Kwon, Soon Tae; Lee, Jun Kyu; Ahn, Jae Sung; Lee, Hwan Do; Chung, Yon Su; Jeong, Ki Ho; Cho, Jun Sik [Chungnam National Univ. College of Medicine, Taejon (Korea, Republic of)

    1999-04-01

    To assess the frequency, location, associated MR findings, and clinical symptoms of the high level lumbar disc herniation(HLDH). A total of 1076 patients with lunbar disc herniation were retrospectively reviewed. MR images of 41 of these with HLDH(T12-L1, L1-2, L2-3) were analysed in terms of frequency, location, and associated MR findings, and correlated with clinical symptoms of HLDH. The prevalence of HLDH was 3.8%(41/1076). HLDH was located at T12-L1 level in four patients(10%), at L1-2 level in 14(34%), at L2-3 level in 21(51%), and at both L1-2 and L2-3 levels in two. The age of patients ranged from 20 to 72 years (mean, 44), and there were 26 men and 16 women. In 11(27%), whose mean age was 32 years, isolated disc herniation was limited to these high lumbar segments. The remaining 30 patients had HLDH associated with variable involvement of the lower lumbar segments. Associated lesions were as follow : lower level disc herniation(14 patients, 34%); apophyseal ring fracture(8 patients, 19%); Schmorl's node and spondylolisthesis (each 6 patients, each 14%); spondylolysis(3 patients, 7%); and retrolisthesis(2 patients, 5%). In 20 patients(49%) with HLDH(n=41), there was a previous history of trauma. Patients with HLDH showed a relatively high incidence of associated coexisting abnormalities such as lower lumbar disc herniation, apophyseal ring fracture, Schmorl's node, spondylolysis, and retrolisthesis. In about half of all patients with HLDH there was a previous history of trauma. The mean age of patients with isolated HLDH was lower; clinical symptoms of the condition were relatively nonspecific and their incidence was low.

  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. 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.

  5. Using geographical information system for spatial evaluation of canine extruded disc herniation.

    Science.gov (United States)

    Daraban, Constantin; Murino, Carla; Marzatico, Giuseppe; Mennonna, Giuseppina; Fatone, Gerardo; Auletta, Luigi; Miceli, Fabiana; Vulpe, Vasile; Meomartino, Leonardo

    2014-11-01

    Disc herniation is one of the most common pathologies of the vertebral column in dogs. The aim of this study was to develop a geographical information system (GIS)-based vertebral canal (VC) map useful for spatial evaluation of extruded disc herniation (EDH) in dogs. ArcGIS® was used to create two-dimensional and three-dimensional maps, in which the VC surface is divided into polygons by lines representing latitude and longitude. Actual locations and directions of the herniated disc material were assessed by a series of 142 computer tomographies of dogs collected between 2005 and 2013. Most EDHs were located on the cervical and transitional regions (thoraco-lumbar and lumbo-sacral) and shown at the level of the ventro- cranial and ventro-central polygons created. Choropleth maps, highlighting the distribution and the location/direction patterns of the EDHs throughout the VC, were produced based on the frequency of the ailment. GIS proved to be a valuable tool in analysing EDH in dogs. Further studies are required for biomechanical analysis of EDH patterns.

  6. Using geographical information system for spatial evaluation of canine extruded disc herniation

    Directory of Open Access Journals (Sweden)

    Constantin Daraban

    2014-11-01

    Full Text Available Disc herniation is one of the most common pathologies of the vertebral column in dogs. The aim of this study was to develop a geographical information system (GIS-based vertebral canal (VC map useful for spatial evaluation of extruded disc herniation (EDH in dogs. ArcGIS® was used to create two-dimensional and three-dimensional maps, in which the VC surface is divided into polygons by lines representing latitude and longitude. Actual locations and directions of the herniated disc material were assessed by a series of 142 computer tomographies of dogs collected between 2005 and 2013. Most EDHs were located on the cervical and transitional regions (thoraco-lumbar and lumbo-sacral and shown at the level of the ven- tro-cranial and ventro-central polygons created. Choropleth maps, highlighting the distribution and the location/direction patterns of the EDHs throughout the VC, were produced based on the frequency of the ailment. GIS proved to be a valuable tool in analysing EDH in dogs. Further studies are required for biomechanical analysis of EDH patterns.

  7. 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.

  8. Huge Intracanal lumbar Disc Herniation: a Review of Four Cases

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    Farzad Omidi-Kashani

    2016-01-01

    Full Text Available Lumbar disc herniation (LDH is the most common cause of sciatica and only in about 10% of the affected patients, surgical intervention is necessary. The side of the patient (the side of most prominent clinical complaints is usually consistent with the side of imaging (the side with most prominent disc herniation on imaging scans. In this case series, we presented our experience in four cases with huge intracanal LDH that a mismatch between the patient’s side and the imaging’s side was present. In these cases, for deciding to do the operation, the physicians need to rely more on clinical findings, but for deciding the side of discectomy, imaging characteristic (imaging side may be a more important criterion.

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

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    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.

  10. 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%.

  11. Intervertebral Disc Herniation Treated by Comprehensive Therapy

    Institute of Scientific and Technical Information of China (English)

    SUN Yu; HUANG Guo-qi

    2007-01-01

    In the treatment of 169 cases of the patients sick with intervertebral disc hemiation by integrated application of acupuncture therapy,Chinese massage therapy and herbal fumigation method.the results showed cure in 129 cases.improvement in 33 cases and failure in 7 cases,and the total effective rate was 95.9%.

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

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    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.

  13. Posteriorly migrated thoracic disc herniation: a case report

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    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.

  14. 颈椎间盘突出程度与颈椎X线片相关指标测量值的相关性研究%The correlation analysis of the degree of cervical intervertebral disc herniation associated with cervical X-ray radiography index

    Institute of Scientific and Technical Information of China (English)

    蒋维利; 申才良; 董福龙; 章仁杰; 汪军; 朱晓红; 张华庆

    2015-01-01

    Objective To investigate the relationship of the related parameters of X-ray and the severity of cervical spinal cord compression caused by disc herniation in patients with single segment spondylotic myelopathy. Methods Clinical data of sixty paitents with single segment spondylotic myelopathy in the First Affiliated Hospital of Anhui Medical University from August 2012 to March 2014 were retrospectively analyzed. All the patients, aged from 42 to 65 (58. 4±9. 3), were male. According to the compression ratio ( E value) of cervical spinal cord in sagittal MRI images, all the patients were firstly divided into group Ⅰ, II and Ⅲ. The ratio of cervical spinal crosscutting area ( S1 ) to effective cervical canal crosscutting area ( S0 ) in cross-sectional imagings of cervical spine MRI was then calculated to reflect the degree of intervertebral disc herniation. Furthermore, the following indicators in cervical X-ray in different postures were measured for each case: the range of motion of the responsibility of intervertebral space ( B value) , the height of the anterior of intervertebral space ( D value) , Cobb angle of C2-7 , and the area of intervertebral foramen ( M value) . Linear correlation regression was used to study the relationship of the severity of cervical spinal cord compression and the above observation indexes. Results There were significant differences in the ratio of S1/S0 , E value, B value, D value, M value and Cobb angle of C2-7 among three groups (F values were 44. 187, 112. 789, 7. 232, 3. 778, 3. 232 and 15. 813, respectively. all P values<0. 05). E value, B value, D value, M value and Cobb angle of C2-7 decreased with the increase of the ratio of S1/S0 . These indicated that E value, B value, D value, M value and Cobb angle of C2-7 were negatively correlated with the ratio of S1/ S0 ( R values were-0. 821, -0. 581, -0. 378, -0. 419 and-0. 576, respectively, all P values<0. 05). The multiple linear regression results showed that B value, D

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

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

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    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.).

  17. Clinical observation of computed tomography guided percutaneous targeted coblation nucleoplasty in treatment of cervical intervetebral disc herniation%CT引导下低温等离子靶点消融治疗颈椎间盘突出症的效果观察

    Institute of Scientific and Technical Information of China (English)

    赵治涛; 张增臻; 肖珂青; 高宝峰; 阴祖栋; 李秀华

    2016-01-01

    目的:探讨 CT 引导下经皮穿刺低温等离子靶点消融治疗颈椎间盘突出症的临床效果。方法选择经 CT 或 MRI 检查明确诊断的颈椎间盘突出症患者50例,均行 CT 引导下经皮穿刺低温等离子靶点消融治疗。术后3个月进行随访,观察治疗效果。结果所有患者均术后随访3个月,依据 Macnab 疗效评定标准评定治疗效果。优19例(37.5%),良29例(58.3%),差2例(4.2%),优良率92.5%,VAS 评分较术前明显降低(P <0.05)。结论CT 引导下经皮穿刺低温等离子靶点消融术是一种治疗颈椎间盘突出症安全、有效、微创的方法。%Objective To investigate the effect of CT guided percutaneous targeted coblation nucleoplasty in treatment of cervical intervetebral disc herniation.Methods Fifty patients who were diagnosed with cervical intervetebral disc herniation by CT or MRI were received the treatment of CT guided percutaneous targeted coblation nucleoplasty and the follow-up check after operation.The effects according to Macnab therapeutic criteria and VAS method were evaluated and recorded before operation and after operation at the third day,2 weeks,3 months.Results All patients accepted follow-up three months after operation.The effects were assessed by Macnab therapeutic criteria:1 9 cases were excellent (37.5%),29 cases good (58.3%),2 cases bad (4.2%),and the effective rate was 92.5%.The VAS scores in three months after operation were significantly lower than that before operation (P <0.05 ). Conclusion Computed tomography guided percutaneous targeted coblation nucleoplasty is a safe,effective and minimally invasive method for treating cervical intervetebral disc herniation.

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

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    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.

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

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    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.

  20. 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.

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

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    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.

  2. 低温等离子射频消融术与射频靶点热凝术治疗颈椎间盘突出症的临床疗效观察%Clinical observation of coblation nucleoplasty and radiofrequency thermocoagulation in the treatment target for cervical disc herniation

    Institute of Scientific and Technical Information of China (English)

    陈建卫; 李晓冰; 郭卫平; 吴智群

    2012-01-01

    Objective To analyze the different therapeutic effect between the coblation nucleoplasty and radiofrequency thermo-coagulation in the treatment target for cervical disc herniation. Methods The clinical efficacy of 80 cases with cervical disc herniation were retrospectively analysed. 38 cases treated with coblation nucleoplasty and 42 cases treated with radiofrequency thermocoagula-tion. VAS scores 3d later, JOA scores 1 month and 3 months postoperation were analysed comparatively between two groups. Results The results of VAS and JOA scores showed that the treatment of cervical disc herniation was of significant effect with coblation nucleoplasty and radiofrequency thermocoagulation in the treatment target, while the coblation nucleoplasty was more effective than the radiofrequency thermocoagulation at postoperative 3 d and 30 d (P<0. 05) , there was no significant different between coblation nucleoplasty and the radiofrequency thermocoagulation at postoperative 180 d. Conclusion The patients with cervical disc herniation treated by coblation nucleoplasty have light reactions and can recovery quickly compared with radiofrequency thermocoagulation in the short-term, but the clinical efficacy has no significant difference between both coblation nucleoplasty and radiofrequency thermocoagulation in the long-term.%目的 探讨低温等离子射频消融术与射频靶点热凝术治疗颈椎间盘突出症临床疗效的对比.方法 回顾性分析因颈椎间盘突出症住院80例患者的临床疗效,其中行低温等离子射频消融术38例,行射频靶点热凝术42例.比较2组术后3 d VAS评分、术后1月及术后6月的JOA评分.结果从患者术后3 d VAS评分,术后1月、6月JOA评分比较来看,低温等离子射频消融术与射频靶点热凝术对颈椎间盘突出症具有显著疗效.低温等离子射频消融术在术后3 d、1月的疗效优于射频靶点热凝术(P<0.05),而术后6月再次对患者进行随访发现,低温等离子

  3. 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.

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    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

  4. PERCUTANEOUS DISCECTOMY: A CURRENT TREATMENT FOR LUMBAR DISC HERNIATION

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    Pablo Gerardo Lima-Ramírez

    Full Text Available ABSTRACT Objective: Describe the functional outcomes of patients with contained lumbar disc herniation (L4-L5, L5-S1 treated with manual percutaneous nucleotomy (MPN and demonstrate that it remains a technique with good results. Methods: A prospective, longitudinal study with 110 patients contained with lumbar disc herniation (LDH treated with (MPN. The evaluation was pre-surgical and 4, 30, 180 and 365 days after the surgery. We used Numeric Pain Scale (NPS, Oswestry Disability Index (ODI and Macnab criteria. Descriptive and inferential statistics for differences. Results: N=110: 58 (52.72% men, 52 (47.27% women; average age 37.95 years (14-56 ± 10.60; most affected level: L4-L5 in 63 (57.14% patients. NPS preoperative average: 7.75 (5-9 ± 1.12, and at 365 days: 2.14 (0-7 ± 2.37. The mean preoperative ODI was 37% (28%-40% + 3.06, and at 365 days 9.52% (0%-40% + 13.92. The prognosis (ODI was good to 79 (71.81% patients at 365 days, regular in 26 (23.63% and poor in 5 (4.57%, corresponding respectively to patients with no, mild, moderate and severe disability. The Macnab criteria showed similar results (p = 0.00, 95% CI 0.00 to 0.13 - Student's t. Conclusions: The results were good at one-year follow-up (p = 0.00, demonstrating that the MPN is still a good option for lumbosciatic pain relief.

  5. Sagittal spinal alignment in patients with lumbar disc herniation.

    Science.gov (United States)

    Endo, Kenji; Suzuki, Hidekazu; Tanaka, Hidetoshi; Kang, Yupeng; Yamamoto, Kengo

    2010-03-01

    A retrospective cross-sectional study was designed to evaluate total sagittal spinal alignment in patients with lumbar disc herniation (LDH) and healthy subjects. Abnormal sagittal spinal alignment could cause persistent low back pain in lumbar disease. Previous studies analyzed sciatic scoliotic list in patients with lumbar disc herniation; but there is little or no information on the relationship between sagittal alignment and subjective findings. The study subjects were 61 LDH patients and 60 age-matched healthy subjects. Preoperative and 6-month postoperatively lateral whole-spine standing radiographs were assessed for the distance between C7 plumb line and posterior superior corner on the top margin of S1 sagittal vertical axis (SVA), lumbar lordotic angle between the top margin of the first lumbar vertebra and first sacral vertebra (L1S1), pelvic tilting angle (PA), and pelvic morphologic angle (PRS1). Subjective symptoms were evaluated by the Japanese Orthopedic Association (JOA) score for lower back pain (nine points). The mean SVA value of the LDH group (32.7 +/- 46.5 mm, +/- SD) was significantly larger than that of the control (2.5 +/- 17.1 mm), while L1S1 was smaller (36.7 +/- 14.5 degrees ) and PA was larger (25.1 +/- 9.0 degrees ) in LDH than control group (49.0 +/- 10.0 degrees and 18.2 +/- 6.0 degrees , respectively). At 6 months after surgery, the malalignment recovered to almost the same level as the control group. SVA correlated with the subjective symptoms measured by the JOA score. Sagittal spinal alignment in LDH exhibits more anterior translation of the C7 plumb line, less lumbar lordosis, and a more vertical sacrum. Measurements of these spinal parameters allowed assessment of the pathophysiology of LDH.

  6. 早期颈前路手术治疗多节段急性颈椎间盘突出并脊髓损伤的研究%Early anterior approach operation with internal fixation in treatment of acute multilevel cervical disc herniation patients with cervical spinal cord injury

    Institute of Scientific and Technical Information of China (English)

    李晓彬; 刘涛; 程应全; 王伟

    2012-01-01

    Objective To evaluate the clinical effect of early anterior approach operation with internal fixation in treating traumatic cervical disc herniation patients with cervical spinal cord injury.Methods Twenty-three patients with spinal cord injury caused by acute cervical disc herniation,admitted to our hospital from January 2010 to January 2011,were chosen in our study; all patients underwent anterior cervical surgery with the application of titanium mesh plate and cage to perform decompression and reconstruction; 14 patients received surgery within 72 h of injury and other 9 adopted surgery after 72 h of injury.The clinical data and postoperative recovery degree of the spinal cord injury were retrospectively analyzed.Results All patients were followed up for 6 to 13 months (averaged 11 months).X-ray examination showed bony fusion in the fusion segments without loosening/breakage of internal fixation or interbody fusion sinking.Except for 1 patient having grade A according to American Spinal Injury Association (ASIA) criteria enjoyed no recovery after the operation,the remaining patients enjoyed good improvement.The postoperative average Japanese Orthopedic Association (JOA) scale scores were significantly higher than those before surgery; the postoperative average JOA scale scores and recovery ratio of JOA in patients received surgery within 72 h of injury were obviously higher than those in patients received surgery over 72 h of injury (P<0.05).Conclusion Early anterior titanium mesh combined with cage and locking plate operation can make acute cervical disc herniation patients with spinal cord injury get rapid improvement and restoration; the earlier the operation time,the better the recovery degree; surgery can make cervical operation section obtain immediate stability,fusion and clinical effects are satisfied.%目的 探讨早期颈前路手术治疗多节段急性颈椎间盘突出引起的颈脊髓损伤的临床疗效. 方法 河南省人民

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

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    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.

  8. 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

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

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    Gruebl Armin

    2011-09-01

    Full Text Available 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 died because of her deteriorated pulmonary situation, which was influenced by the lumbar disc herniation as it was not possible for her to perform pulmonary drainage techniques properly because of the pain. Conclusions Lumbar disc herniation can lead to a vicious cycle for patients with cystic fibrosis as it may promote pulmonary infections. This report highlights the need to investigate patients correctly.

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

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    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

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

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    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.).

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

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    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.).

  13. 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.

  14. 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).

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

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    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

  16. Symptomatic gas-containing herniated disc with the vacuum phenomenon: mechanism and treatment. Case report.

    Science.gov (United States)

    Lee, Chang-Hyun; Cho, Jae Hoon; Hyun, Seung-Jae; Yoon, Sang Hoon; Kim, Ki-Jeong; Kim, Hyun-Jib

    2012-01-01

    A 76-year-old woman presented with an extremely rare case of symptomatic gas-containing disc herniation manifesting as left posterolateral thigh pain and ankle dorsiflexion motor weakness. The diagnosis was L3-4 vacuum disc associated with epidural pneumorrhachis. The patient underwent partial hemilaminectomy and cyst incision. After incising the cyst, the thecal sac and root were decompressed sufficiently. Vacuum disc is a common phenomenon in the elderly rarely associated with pneumorrhachis and is usually asymptomatic. Symptomatic epidural gas-containing herniated discs with the vacuum phenomenon are very rare. Gas aspiration should be considered, but excision of the gas-containing herniated disc should be performed in patients with neurological deficits, frequent recurrence, or difficult location to approach.

  17. Hérnia discal lombar Lumbar disc herniation

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

    Science.gov (United States)

    Zhang, Daying; Zhang, Yong; 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. Radiofrequency thermocoagulation reduced the hydrolyzation of herniated nucleus pulposus caused by collagenase, as well as the content of hydroxyproline and glycosaminoglycan. Furthermore, 236 patients with lumbar intervertebral disc herniation were treated by target radiofrequency thermocoagulation combined with collagenase chemonucleolysis. The efficiency was evaluated according to Macnab criteria, and the index of lumbar disc herniation (IDH) was compared pre-operation with 3 months post-operation. The post-operative good rate was 66.5% (157/236) at 2 weeks post-operation, and 88.1% (208/236) at 3 months post-operation. In the post-operative follow-up exam, 86.8% of the re-examined cases demonstrated smaller or ablated protrusion, with reduced IDH values from pre-operation, which was statistically significant. No serious complications were detected intra-operatively and post-operatively. In conclusion, target radiofrequency combined with collagenase chemonucleolysis was an effective and safe method for treatment of lumbar intervertebral disc herniation.

  19. Medium-term outcomes of artificial disc replacement for severe cervical disc narrowing

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    Chao-Hung Yeh

    2014-01-01

    Conclusions: Acceptable clinical outcome for treatment of severe cervical disc narrowing with cervical disc replacement technique has been performed in current study. Most patients maintained good postoperative mobility and no significant adjacent level degeneration were found. Cervical disc replacement may be applicable in treatment of severe cervical disc narrowing; however, longer follow-ups are required for ensuring the long-term efficacy of cervical disc replacement.

  20. 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.

  1. 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.

  2. 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)

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

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    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

  4. 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 (plumbar 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.

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

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    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.

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

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    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.)

  7. 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.

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

    Energy Technology Data Exchange (ETDEWEB)

    Fujii, Hideyo; Hachiya, Masafumi; Ohnari, Katsuhiro [Minami Kyosai Hospital, Yokohama (Japan)] [and others

    1995-04-01

    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.).

  9. 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.)

  10. Prevalence and Severity of Preoperative Disabilities in Iranian Patients with Lumbar Disc Herniation

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    Farzad Omidi-Kashani

    2013-12-01

    Full Text Available   Background: Literature recommends that refractory cases with lumbar disc herniation and appropriate indications are better to be treated surgically, but do all the patients throughout the world consent to the surgery with a same disability and pain threshold? We aim to elucidate the prevalence and severity of disabilities and pain in Iranian patients with lumbar disc herniation who have consented to the surgery.   Methods: In this case series study, we clinically evaluated 194 (81 female and 113 male admitted patients with primary, simple, and stable L4-L5 or L5-S1 lumbar disc herniation who were undergoing surgical discectomy. The mean age of the patients was 38.3±11.2 (range: 18-76 years old. Disabilities were evaluated by the items of the Oswestry Disability Index (ODI questionnaire and severity of pain by the Visual Analogue Scale (VAS. Chi-square test was used to compare the qualitative variables. Results: Severe disability (39.2% and crippled (29.9% were the two most common types of disabilities. Mean ODI score was 56.7±21.1 (range: 16-92. Total mean VAS in all patients was 6.1±1.9 (range: 0-10. Sex and level of disc herniation had no statistical effect on preoperative ODI and VAS. The scale of six was the most frequent scale of preoperative VAS in our patients. Conclusion: Iranian patients with lumbar disc herniation who consented to surgery have relatively severe pain or disability. These severities in pain or disabilities have no correlation with sex or level of disc herniation and are not equal with developed countries.

  11. The vertebral signal change on MRI and histological examination of the operated cases for lumbar disc herniations

    Energy Technology Data Exchange (ETDEWEB)

    Kasama, Fumio; Kusakabe, Takashi; Sato, Katsumi; Komatsu, Tetsuro; Watanuki, Munenori; Hara, Seigo [Tohoku Rosai Hospital, Sendai (Japan)

    2002-03-01

    We examined the pre-operative MRI of 97 cases of lumbar disc herniation retrospectively. Ninety-two cases (95%) had vertebral signal changes, end plate erosions and/or vertebral posterior corner changes. Thirty-seven (47%) cases of 78 histological examinations had a cartilaginous end plate. Patients whose MRI showed high signal intensity on both T1 and T2 weighted images near the end plates, had a high incidence of having the end plates in the prolapsed disc herniations. We must recognize the lumbar disc herniation as the injured state of the disc and endplates. (author)

  12. Lumbar disc herniation in a patient with congenital vertebral body anomaly: a case report.

    Science.gov (United States)

    Atabey, Cem; Eroğlu, Ahmet; Topuz, Ali Kivanc; Velioğlu, Murat; Demircan, Mehmet Nusret

    2014-12-01

    Lumbar disc herniation is characterized with low back and leg pain resulting from the degenerated lumbar disc compressing the spinal nerve root. The etiology of degenerative spine is related to age, smoking, microtrauma, obesity, disorders of familial collagen structure, occupational and sports-related physical activity. However, disc herniations induced by congenital lumbar vertebral anomalies are rarely seen. Vertebral fusion defect is one of the causes of congenital anomalies. The pathogenesis of embryological corpus vertebral fusion anomaly is not fully known. In this paper, a 30-year-old patient who had the complaints of low back and right leg pain after falling from a height is presented. She had right L5-S1 disc herniation that had developed on the basis of S1 vertebra corpus fusion anomaly in Lumbar computed tomography. This case has been discussed in the light of literature based on evaluations of Lumbar Computed Tomography (CT) and Magnetic Resonance Imaging (MRI). This case is unique in that it is the first case with development of lumbar disc herniation associated with S1 vertebral corpus fusion anomaly. Congenital malformations with unusual clinical presentation after trauma should be evaluated through advanced radiological imaging techniques.

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

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    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.).

  14. Role of Expression of Inflammatory Mediators in Primary and Recurrent Lumbar Disc Herniation

    Science.gov (United States)

    Dagistan, Yasar; Cukur, Selma; Dagistan, Emine; Gezici, Ali Riza

    2017-01-01

    Objective To assess role of some inflammatory mediators in patients with primary and recurrent lumbar disc herniation. Expression of IL-6, transforming growth factor (TGF)-1, insulin-like growth factor (IGF)-1, and Bcl-2-associated X protein (BAX) have been shown to be more intense in the primary group than the recurrent goup, but this mediators may be important aspects prognostic. Methods 19 patients underwent primary and revision operations between June 1, 2009 and June 1, 2014, and they were included in this study. The 19 patients’ intervertebral disc specimens obtained from the primary procedures and reoperations were evaluated. Expression of IL-6, TGF-1, IGF-1, and BAX were examined immunohistochemically in the 38 biopsy tissues obtained from the primary and recurrent herniated intervertebral discs during the operation. Results For IL-6 expression in the intervertebral disc specimens, there was no difference between the groups. The immunohistochemical study showed that the intervertebral disc specimens in the primary group were stained intensely by TGF-1 compared with the recurrent group. Expression of IGF-1 in the primary group was found moderate. In contrast, in the recurrent group of patients was mild expression of IGF-1. The primary group intervertebral disc specimens were stained moderately by BAX compared with the recurrent group. Conclusion The results of our prognostic evaluation of patients in the recurrent group who were operated due to disc herniation suggest that mediators may be important parameters. PMID:28061491

  15. 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.

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

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    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

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

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    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.

  18. Diaphragm paralysis from cervical disc lesions.

    Science.gov (United States)

    Cloward, R B

    1988-01-01

    An opera singer, who "made her living with her diaphragm", developed a post-traumatic unilateral radiculopathy due to cervical disc lesions, C3 to C6. During one year of severe neck and left arm pain she gradually lost the ability to sing difficult operatic passages which brought an end to her music career. Following a three level anterior cervical decompression and fusion, the neck and arm pain was immediately relieved. One week later her voice and singing ability returned to its full strength and power permitting her to resume her activities as a vocalist. The diagnosis of paresis of the left hemi-diaphragm as part of the cervical disc syndrome was implied by postoperative retrospective inference.

  19. Describing a new syndrome in L5-S1 disc herniation: Sexual and sphincter dysfunction without pain and muscle weakness

    OpenAIRE

    Nezih Akca; Bulent Ozdemir; Ayhan Kanat; Osman Ersagun Batcik; Ugur Yazar; Orhan Unal Zorba

    2014-01-01

    Context: Little seems to be known about the sexual dysfunction (SD) in lumbar intervertebral disc herniation. Aims: Investigation of sexual and sphincter dysfunction in patient with lumbar disc hernitions. Settings and Design: A retrospective analysis. Materials and Methods: Sexual and sphincter dysfunction in patients admitted with lumbar disc herniations between September 2012-March 2014. Statistical Analysis Used: Statistical analysis was performed using the Predictive Analytics SoftWare (...

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

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    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.).

  1. Genotypic and Antimicrobial Characterisation of Propionibacterium acnes Isolates from Surgically Excised Lumbar Disc Herniations

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    Jess Rollason

    2013-01-01

    Full Text Available 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, 52% of the isolates were type II (50% of culture-positive patients, while type IA strains accounted for 28% of isolates (42% patients. Type III (11% isolates; 21% patients and type IB strains (9% isolates; 17% patients were detected less frequently. The MIC values for all isolates were lowest for amoxicillin, ciprofloxacin, erythromycin, rifampicin, tetracycline, and vancomycin (≤1mg/L. The MIC for fusidic acid was 1-2 mg/L. The MIC for trimethoprim and gentamicin was 2 to ≥4 mg/L. The demonstration that type II and III strains, which are not frequently recovered from skin, predominated within our isolate collection (63% suggests that the role of P. acnes in lumbar disc herniation should not be readily dismissed.

  2. Lumbar apophyseal ring fracture and disc herniation: CT and MRI manifestations

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    Lee, Hyeon Kyeong; Kang, Heung Sik [Seoul National University College of Medicine, Seoul (Korea, Republic of); Song, Chi Sung [Young-Deung-Po City Hospital, Seoul (Korea, Republic of)

    1991-07-15

    To understand CT and MR findings and, furthermore, the pathophysiology of the lumbar apophyseal ring fracture (LARF) associated with lumbar disc herniation in 31 cases of LARF (CT was performed in 23, MRI in 18, and both CT and MRI in 12), we studied the age and sex distribution of the patients, history of trauma, shape of bony fragment, number of lesions, lesion sites, associated lumbar disc herniations, and evidence of Scheuermann's disease. Twenty-three out of 31 patients were male, 6 were adolescents, 21 were young adults, and 4 were middled-aged. Arcuate or nodular bone fragment and/or bone defects were detected at the posterior margin of L1 in 2, L2 in 1, L3 in 1, L4 in 10, L5 in 20 and S1 in 7 patients. Eight patients showed multiple LARF, and 13 showed multiple lumbar disc herniations. Radiologic evidence of Scheuermann's disease was obvious in 9 patients. Only 6 patients had a history of evident trauma. CT and MRI showed a similar detection rate of bone fragments and defects. We concluded that LARF would be encountered in young male patients with multiple lumbar disc herniations and evidence of Scheuermann's disease.

  3. 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.

  4. Factors for Predicting Favorable Outcome of Percutaneous Epidural Adhesiolysis for Lumbar Disc Herniation

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    Sang Ho Moon

    2017-01-01

    Full Text Available Background. Lower back pain is a common reason for disability and the most common cause is lumbar disc herniation. Percutaneous epidural adhesiolysis has been applied to relieve pain and increase the functional capacity of patients who present this condition. Objectives. In this study, we retrospectively evaluated the factors which predict the outcome of percutaneous epidural adhesiolysis in patients who were diagnosed with lumbar disc herniation. Methods. Electronic medical records of patients diagnosed with lumbar disc herniation who have received percutaneous epidural adhesiolysis treatment were reviewed. The primary outcome was the factors that were associated with substantial response of ≥4 points or ≥50% of pain relief in the numerical rating scale pain score 12 months after the treatment. Results. Multivariate logistic regression analysis demonstrated that the presence of high-intensity zone (HIZ at magnetic resonance imaging was a predictor of substantial response to percutaneous epidural adhesiolysis for 12 months (P=0.007. The presence of a condition involving the vertebral foramen was a predictor for unsuccessful response after 12 months (P=0.02. Discussion and Conclusion. The presence of HIZ was a predictor of favorable long-term outcome after percutaneous epidural adhesiolysis for the treatment of lower back pain with radicular pain caused by lumbar disc herniation.

  5. 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

  6. Does Duration of Preoperative Sciatica Impact Surgical Outcomes in Patients with Lumbar Disc Herniation?

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    Farzad Omidi-Kashani

    2014-01-01

    Full Text Available Background. In lumbar disc herniation, most authors recommend nonoperative treatment for the first few weeks of presentation, but what about the upper limit of this golden period? The aim of this study is to assess the effect of preoperative sciatica duration on surgical outcome of lumbar disc herniation. Methods. We retrospectively evaluated 240 patients (124 males and 116 females with a mean age of 36.4±5.9 years (range 16 to 63 surgically treated due to primary stable L4-L5 disc herniation. The patients were placed into two groups: with more and less than 12-month duration of preoperative sciatalgia. Disability and pain were measured by Oswestry Disability Index (ODI and Visual Analogue Scale (VAS. Wilcoxon test and Mann-Whitney U test were used for statistical analysis. Results. Total mean duration of preoperative sciatalgia and follow-up period were 13.3 months (range 2 to 65 and 33.7±5.1 months (range 24 to 72, respectively. Comparison between the groups showed that duration of preoperative sciatalgia either less or more than 12 months did not affect the surgical outcomes significantly. Conclusions. More or less than 12-month duration of preoperative sciatalgia may not affect the surgical outcomes of simple lumbar disc herniation in the patients undergoing discectomy.

  7. [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.

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

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    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.

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

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    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.).

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

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

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    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.

  13. 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

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

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    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

  15. Evaluation of epidural blockade as therapy for patients with sciatica secondary to lumbar disc herniation

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    Rogerio Carlos Sanfelice Nunes

    2016-08-01

    Full Text Available ABSTRACT OBJECTIVE: Sciatic pain secondary to lumbar disc herniation is a complex condition that is often highly limiting. The causes of pain in disc herniation are multifactorial. Two physiopathological mechanisms are involved in discogenic pain: mechanical deformation of nerve roots and a biochemical inflammatory component resulting from contact between the intervertebral disc and neural tissue, by way of the nucleus pulposus. The aim of this study was to evaluate the efficacy and safety of epidural blockade as therapy for bulging lumbar disc herniation. METHODS: A clinical study was conducted based on a retrospective and prospective survey. The blockade consisted of interlaminar puncture and bolus drug delivery. The number of procedures varied according to the clinical response, as determined through weekly evaluations and then 30, 90, and 180 days after the final session. A total of 124 patients who received one to five blockades were evaluated. RESULTS: The success rate (defining success as a reduction in sciatic pain of at least 80% was 75.8%. CONCLUSION: The results demonstrated the therapeutic action of epidural blockade over the short term, i.e. in cases of acute pain, thus showing that intense and excruciating sciatic pain can be relieved through this technique. Because of the multifactorial genesis of sciatica and the difficulties encountered by healthcare professionals in treating this condition, epidural blockade can become part of therapeutic arsenal available. This procedure is situated between conservative treatment with an eminently clinical focus and surgical approaches.

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

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    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.

  17. Intradural lumbar disc herniation after percutaneous endoscopic lumbar discectomy: case report.

    Science.gov (United States)

    Tamaki, Yasuaki; Sakai, Toshinori; Miyagi, Ryo; Nakagawa, Takefumi; Shimakawa, Tateaki; Sairyo, Koichi; Chikawa, Takashi

    2015-09-01

    A 64-year-old man was referred to the authors with low-back pain (LBP) and right leg pain with a history of previously diagnosed lumbar disc herniation (LDH) at L4-5. He had undergone 2 percutaneous endoscopic lumbar discectomies (PELDs) for the herniation at another institution, and according to the surgical record of the second surgery, a dural tear occurred intraoperatively but was not repaired. Postoperative conservative treatments such as an epidural block and blood patch had not relieved his persistent LBP or right leg pain. Upon referral to the authors, MRI and myelography revealed an intradural LDH. The herniated mass was removed by durotomy, and posterior lumbar interbody fusion was performed. His symptoms were partially improved after surgery. Primary suture is technically difficult when a dural tear occurs during PELD. Therefore, close attention should be paid to avoiding such tears, and surgeons should increase their awareness of intradural LDH as a possible postoperative complication of PELD.

  18. A medical record of lumbar disc herniation%腰间盘突出医案一则

    Institute of Scientific and Technical Information of China (English)

    陈艳艳; 杨秋茹; 侯献兵

    2016-01-01

    本文介绍腰间盘突出医案一则,可知针灸治疗腰间盘突出确有实效,为相关治疗提供参考。%In this article, a medical record of treating lumbar disc herniation was introduced;a deifnite effcacy of acupuncture on lumbar disc herniation was showed;and this study provided more reference for relevant treatment.

  19. 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

  20. 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.

  1. RESULTS OF TREATMENT OF ACUTE LUMBAR DISC HERNIATION WITH TRANSFORAMINAL NERVE ROOT BLOCK

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    EMILIANO NEVES VIALLE

    Full Text Available ABSTRACT Objective: To determine the efficacy of anesthetic transforaminal nerve root block in patients with sciatica secondary to lumbar disc herniation through a prospective observational study. Methods: The study included 176 patients from a private clinic undergoing transforaminal injection performed by a single spinal surgeon. The patients were assessed after two weeks, three months and six months regarding to the improvement of the pain radiating to the lower limbs. In case of persistent symptoms, patients could choose to perform a new nerve root block and maintenance of physical therapy or be submitted to conventional microdiscectomy. Results: By the end of six-month follow-up of the 176 patients, 116 had a favorable outcome (95 after one block and 21 after two blocks, and only 43 required surgery. Conclusion: The results of our study suggest a positive effect of transforaminal block for the treatment of sciatica in patients with lumbar disc herniation.

  2. 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.

  3. The effect of movement therapy on quality of life of patients after lumbar disc herniation surgery

    Directory of Open Access Journals (Sweden)

    Alimohammadi N

    2015-08-01

    Full Text Available Background and Objective: Patients after lumbar disc herniation surgery experience chronic pain and disability and can impact on their quality of life. This study aimed to determine the effect of movement therapy on quality of life of patients after lumbar disc herniation surgery. Materials and Method: The current clinical trial study with before and after design in three stages was done on patients with lumbar disc herniation surgery in one of the hospitals in Isfahan in 2013. Patients were selected through convenience sampling and then were randomly allocated into two intervention and control groups (32 patients in each group. The movement program was implemented 4 weeks after surgery for 2 weeks. Data were collected through demographic questionnaire and SF-36 quality of life questionnaire. Data were analyzed by SPSS-18 using independent t-test and repeated measures ANOVA. Results: There has been a significant increase in the mean of overall quality of life score in intervention group 6 weeks (65.2 ± 7.45 and 3 months after intervention (70.9 ± 8.2, in compare with before the intervention (31.5 ± 6.05 (p < 0.001. Also the mean of overall quality of life score showed the significant difference in two groups (p < 0.001. Physical and psychological aspects increased significantly in both groups in the period of 6 weeks and 3 months after intervention, the increase was greater in intervention group than control group. (p<0.001. Conclusion: Movement therapy promotes the quality of life of patients after lumbar disc herniation surgery. Thus, using this program by health care professionals in improving the quality of life of patients is recommended.

  4. Atypical Presentation of Thoracic Disc Herniation: Case Series and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Ali Shirzadi

    2013-01-01

    Full Text Available Modern imaging has revealed that thoracic disc herniation (TDH has a prevalence of 11–37% in asymptomatic patients. Pain, sensory disturbances, myelopathy, and lower extremity weakness are the most common presenting symptoms, but other atypical extraspinal complaints, such as gastrointestinal or cardiopulmonary discomfort, may be reported. Our objective is to make providers familiar with TDH’s atypical symptoms to help avoid potential serious consequences created by a delay in diagnosis. We report the cases of two patients who each presented with atypical extraspinal symptoms secondary to a TDH. One patient presented with a chronic history of nausea, emesis, and chest tightness and MRI showed a large right paramedian disc herniation at T7-8. A second patient reported chronic constipation, buttock and leg burning pain, gait instability, and urinary frequency; an MRI of his thoracic spine demonstrated a central disc herniation at T10-11. TDH can present with vague extraspinal symptoms and unfamiliarity with these symptoms can lead to misdiagnosis with progression of the disease and unnecessary diagnostic tests and medical procedures. Therefore, TDH should be included in the differential diagnosis of patients with negative gastrointestinal, genitourinary, and cardiopulmonary system basic studies.

  5. Primary immune system responders to nucleus pulposus cells: evidence for immune response in disc herniation

    Directory of Open Access Journals (Sweden)

    K Murai

    2010-01-01

    Full Text Available Although intervertebral disc herniation and associated sciatica is a common disease, its molecular pathogenesis is not well understood. Immune responses are thought to be involved. This study provides direct evidence that even non-degenerated nucleus pulposus (NP cells elicit immune responses. An in vitro colony forming inhibition assay demonstrated the suppressive effects of autologous spleen cells on NP cells and an in vitro cytotoxicity assay showed the positive cytotoxic effects of natural killer (NK cells and macrophages on NP cells. Non-degenerated rat NP tissues transplanted into wild type rats and immune-deficient mice demonstrated a significantly higher NP cell survival rate in immune-deficient mice. Immunohistochemical staining showed the presence of macrophages and NK cells in the transplanted NP tissues. These results suggest that even non-degenerated autologous NP cells are recognized by macrophages and NK cells, which may have an immunological function in the early phase of disc herniation. These findings contribute to understanding resorption and the inflammatory reaction to disc herniation.

  6. The Relationship between Lifestyle and Pain in Patients with Spinal Disc Herniation

    Directory of Open Access Journals (Sweden)

    Monireh Dadashzadeh

    2016-12-01

    Full Text Available Due to the rapid growth of the industries and constantly involvement of the new technologies into the human lives, the lifestyles of the people are altering. Simultaneously few new disorders in their lifestyles and diseases in their lives are also emerging. The spinal cord abnormalities i.e., the spinal disc herniation and/or low back pain is one of them which have made the life of some people very miserable (Farahani et al., 2012. Indeed the overall lifestyle of a human being regulates the musculoskeletal symptoms. Differences in lifestyle and psychosocial factors associated with individuals' lifestyle are effective in experiencing the level of pressure in musculoskeletal systems. Studies related to the lifestyle and musculoskeletal system, including pain and inflammation, are largely correlate (Mikkonen et al., 2015. Proper knowledge regarding the relationship between lifestyle and spinal disc herniation is very important. Social habits such as diet, exercise, weight gain, anxiety, and depression can cause changes in the spinal cord and spinal disc herniation (Kadow et al., 2014. Further, some of the lifestyle parameters such as smoking, nutrition, BMI, level of activity, sleep status, stress, and anxiety are also seen to reduce the need for medication or avoid and reduce musculoskeletal pain (Dean et al., 2015. As per Bohman et al. (2014 people with a healthy lifestyle suffer 66% less from low back pain than those who have unhealthy lifestyles.

  7. 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.

  8. A Rare Case of Progressive Palsy of the Lower Leg Caused by a Huge Lumbar Posterior Endplate Lesion after Recurrent Disc Herniation

    Science.gov (United States)

    Higashino, Kosaku; Fumitake, Tezuka; Yamashita, Kazuta; Hayashi, Fumio; Sairyo, Koichi

    2016-01-01

    A lesion of the lumbar posterior endplate is sometimes identified in the spinal canal of children and adolescents; it causes symptoms similar to those of a herniated disc. However, the pathology of the endplate lesion and the pathology of the herniated disc are different. We present a rare case of a 23-year-old woman who developed progressive palsy of the lower leg caused by huge lumbar posterior endplate lesion after recurrent disc herniation. PMID:27648326

  9. A Rare Case of Progressive Palsy of the Lower Leg Caused by a Huge Lumbar Posterior Endplate Lesion after Recurrent Disc Herniation

    Directory of Open Access Journals (Sweden)

    Masatoshi Morimoto

    2016-01-01

    Full Text Available A lesion of the lumbar posterior endplate is sometimes identified in the spinal canal of children and adolescents; it causes symptoms similar to those of a herniated disc. However, the pathology of the endplate lesion and the pathology of the herniated disc are different. We present a rare case of a 23-year-old woman who developed progressive palsy of the lower leg caused by huge lumbar posterior endplate lesion after recurrent disc herniation.

  10. 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.

  11. Diagnostic significance of CT discography for lumbar disc herniation

    Energy Technology Data Exchange (ETDEWEB)

    Yanagida, Masaaki; Fujimura, Yoichi; Toyama, Yoshiaki; Koyanagi, Takahiro; Ueno, Mitsuru; Satomi, Kazuhiko (Keio Univ., Tokyo (Japan). School of Medicine); Hirabayashi, Kiyoshi

    1992-08-01

    CT discograms of 192 intervertebral disks from 107 patients with lumbar disk herniation were compared with conventional discograms and surgical findings. According to the shape and fissure of the nucleus pulposus, CT discographic appearance fell into (A) round or oval, (B) monoarborized, (C) polyarborized, and (D) diffuse. Types A, B, and D on CT discography well correlated with conventional discographic type I (round or oval) and II (bilocular), III (monoarborized), and V (diffuse), respectively. Correlation between type C on CT discography and type IV on conventional discography was only found in approximately 50% of the patients. According to the degree and feature of enlargement of the spinal nucleus, CT discographic appearance also fell into (a) the inner posterior margin, (b) the outer posterior margin with definite border and continuation, and (c) the outer posterior margin with no evidence of definite border or continuation. Type b corresponded well to protrusion and prolapse, and type c to extrusion and sequestration on surgery. This has important implications concerning the value of CT discography in detecting the presence or absence of perforation of the posterior longitudinal ligament. In comparison with the capability of conventional discography, CT discography may be more sensitive method for detecting transverse pathophysiology of the intervertebral disk. (N.K.).

  12. Posterior pelvic pain provocation test is negative in patients with lumbar herniated discs.

    Science.gov (United States)

    Gutke, Annelie; Hansson, Eva Roos; Zetherström, Gunilla; Ostgaard, Hans Christian

    2009-07-01

    The classification of pelvic girdle pain can only be reached after lumbar causes have been excluded by a clinical examination. During clinical examination, the posterior pelvic pain provocation test is a well-established method for verifying pelvic girdle pain. However, a criticism of pelvic pain provocation tests is that they may have an effect on lumbar structures, thus yielding false-positive results. The posterior pelvic pain provocation test was performed with four groups of patients: patients with computed tomography-verified disc herniations (1) on the waiting list for surgery (14 women; 9 men); (2) 6 weeks after disc surgery (18 women, 12 men); (3) pregnant women seeking care for pelvic girdle pain (n = 25); and (4) women with persistent pelvic girdle pain after delivery (n = 32). The sensitivity of the posterior pelvic pain provocation test was 0.88 and the specificity was 0.89. The positive predictive value was 0.89 and the negative predictive value was 0.87. Analysis of only women showed similar results. In our study, the posterior pelvic pain provocation test was negative in patients with a well-defined lumbar diagnosis of lumbar disc herniation, both before and after disc surgery. Our results are an important step toward the more accurate classification of lumbopelvic pain.

  13. Medium-term outcomes of artificial disc replacement for severe cervical disc narrowing

    Institute of Scientific and Technical Information of China (English)

    Chao-Hung Yeh; Che-Wei Hung; Cheng-Hsing Kao; Chien-Ming Chao

    2014-01-01

    Objective:To determine if theBryan cervical disc prosthesis could relieve objective neurological symptoms, signs, and restore mobility in patients with severe cervical disc narrowing. Methods:Clinical data of thirty-two patients underwentBryan cervical disc replacement has been collected fromApril2006 toFebruary2010.Severe cervical disc narrowing with gradeV disc degeneration were included in this study.Bryan cervical disc prostheses have been implanted through anterior approach.JapaneseOrthopedicsAssociation(JOA) score, visual analog scale, Odom’s scale, and flexion-extension radiological follow-ups were applied for evaluations. Results:A total of41Bryan disc prostheses from32 patients with an average follow-up duration of33.5 months(range23 to44 months) were evaluated.Clinical functions of patients were significantly improved.Preoperative averaged visual analog scale score of6.3±2.2 was decreased to1.3±1.2(at36 months,P<0.001), while preoperative averagedJOA score of14.4±1.2 was increased to16.3±0.9(at36 months,P<0.001).Thirty of32 patients received excellent to good outcomes inOdom’s scale.Averaged mobility was restored to(9.9±3.2)°at the last follow-up evaluation of36 months.No subsidence or migration of implant was identified. Conclusions:Acceptable clinical outcome for treatment of severe cervical disc narrowing with cervical disc replacement technique has been performed in current study.Most patients maintained good postoperative mobility and no significant adjacent level degeneration were found.Cervical disc replacement may be applicable in treatment of severe cervical disc narrowing; however, longer follow-ups are required for ensuring the long-term efficacy of cervical disc replacement.

  14. Cervical spine CT scan

    Science.gov (United States)

    ... defects of the cervical spine Bone problems Fracture Osteoarthritis Disc herniation Risks Risks of CT scans include: ... Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, ...

  15. 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.)

  16. Significance of Gd-DTPA enhanced MRI in lumbar disc herniation

    Energy Technology Data Exchange (ETDEWEB)

    Hijikuro, Taiji; Nakai, Osamu; Shindo, Shigeo; Mizuno, Kouichi; Otani, Kazuyuki; Yamaura, Isakichi [Kudanzaka Hospital, Tokyo (Japan)

    2001-04-01

    To know the significance of enhanced MRI images for prediction of prognosis of lumbar disc herniation, the images of 202 patients were retrospectively compared in relation with their findings at surgery, histo-pathological ones, clinical process and morphology. After intravenous injection of soluble Gd, T1 and T2-weighted imaging had been done with Yokogawa SignaConta (0.5T). Surgery was conducted on 99 patients and conservative therapy, on 103. Patients were classified into 3 groups: those giving enhanced effect in and behind the herniation, and without the effect. The enhancement was observed in 62%. Bad prognosis was seen in 37% of patients without the enhancing effect and the enhanced MRI was concluded to be useful for prediction of prognosis. (K.H.)

  17. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  19. Surgical versus conservative treatment for lumbar disc herniation: a prospective cohort study

    Science.gov (United States)

    Gugliotta, Marinella; da Costa, Bruno R; Dabis, Essam; Theiler, Robert; Jüni, Peter; Reichenbach, Stephan; Landolt, Hans; Hasler, Paul

    2016-01-01

    Objectives Evidence comparing the effectiveness of surgical and conservative treatment of symptomatic lumbar disc herniation is controversial. We sought to compare short-term and long-term effectiveness of surgical and conservative treatment in sciatica symptom severity and quality of life in patients with lumbar disc herniation in a routine clinical setting. Methods A prospective cohort study of a routine clinical practice registry consisting of 370 patients. Outcome measures were the North American Spine Society questionnaire and the 36-Item Short-Form Health Survey to assess patient-reported back pain, physical function, neurogenic symptoms and quality of life. Primary outcomes were back pain at 6 and 12 weeks. Standard open discectomy was assessed versus conservative interventions at 6, 12, 52 and 104 weeks. We filled in missing outcome variable values with multiple imputation, accounted for repeated measures within patients with mixed-effects models and adjusted baseline group differences in relevant prognostic indicators by inverse probability of treatment weighting. Results Surgical treatment patients reported less back pain at 6 weeks than those receiving conservative therapy (−0.97; 95% CI −1.89 to −0.09), were more likely to report ≥50% decrease in back pain symptoms from baseline to 6 weeks (48% vs 17%, risk difference: 0.34; 95% CI 0.16 to 0.47) and reported less physical function disability at 52 weeks (−3.7; 95% CI −7.4 to −0.1). The other assessments showed minimal between-group differences with CIs, including the null effect. Conclusions Compared with conservative therapy, surgical treatment provided faster relief from back pain symptoms in patients with lumbar disc herniation, but did not show a benefit over conservative treatment in midterm and long-term follow-up. PMID:28003290

  20. 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.

  1. [Specific lumbocrural pain and the individual diagnosis of lumbar intervertebral disc herniation].

    Science.gov (United States)

    Huang, Shi-Rong; Shi, Yin-Yu; Zhan, Hong-Sheng

    2014-03-01

    Pain is all lumbocrural pain cases very common clinical symptoms,but the etiology, pathology, site (range or area), intensity, nature, evolution situation and influence factors of pain usually has some certain characteristics and rules, these differences particularly are regarded as the primary and important basis or clue for the clinical diagnosis and differential diagnosis of related diseases. In addition, according to these differences can determine the individual diagnosis of lumbar intervertebral disc herniation as well, including typical and atypical, simple and compound, the general and special cases, these be- come the basis to determine the individualized therapeutic schedule of this disese.

  2. Brucellar discitis as a cause of lumbar disc herniation: a case report.

    Science.gov (United States)

    Yilmaz, Cem; Akar, Aykan; Civelek, Erdinç; Köksay, Berkay; Kabatas, Serdar; Cansever, Tufan; Caner, Hakan

    2010-01-01

    Brucellosis is an infectious disease spread by consumption of non-pasteurized milk products or through contact with infected animals. Spinal involvement is one of the most important complications and the lumbar area is the most frequently affected site. Among the neurological consequences, nerve root compression can be a result of epidural abscess, granuloma or discitis secondary to vertebral body involvement. In this case report we present a 50-year-old male patient with brucellar discitis without spondylitis which caused lumbar disc herniation. We want to emphasize that discitis should also be considered in differential diagnosis of nerve root compression in suspected cases.

  3. 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

    INTRODUCTION: Following the municipal reform in Denmark in January 2007, the municipalities gained responsibility for post-operative rehabilitation. In the Region of Southern Denmark, this task was decentralised to 22 municipalities, which implied a possible risk for considerable variation...... 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...

  4. 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...... for enhanced cooperation between hospitals and rehabilitation centres. CONCLUSION: Rehabilitation was broadly similar, and patient outcome after one year did not differ significantly across the 22 municipalities or between the five largest samples. In general, all municipalities request enhanced cooperation...

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

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    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.

  6. 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

  7. 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

    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...... with 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.......35[0.14;0.56]). Moreover, larger herniation size predicted a statistically significant reduction in both dural sac area (β-0.35[-0.58;-0.13]) and disc height (β-0.50[-0.81;-0.20]). CONCLUSIONS: On average, most LDHs do not change over a four- to eight-year period. However, larger herniation size predicts a reduction...

  8. 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

  9. 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.

  10. 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.

  11. 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.

  12. Changes of MR imaging by course of time after surgery for lumbar disc herniation

    Energy Technology Data Exchange (ETDEWEB)

    Matsubayashi, Yasutomo (Juntendo Univ., Tokyo (Japan). School of Medicine); Yoshioka, Toshitaka; Yokota, Tohru; Noike, Masatoshi; Endo, Akihiko; Yamauchi, Hiroo; Kazui, Hideo

    1993-02-01

    Fourteen patients with lumber disc herniation underwent magnetic resonance (MR) scanning before and one, 3, 6 and 12 months after LOVE method. The degree of compression of the dural canal on pre- and post-operative sagittal images and the sectional area of the dural canal on axial images were measured to evaluate postoperative repair and decompression of the dural canal. Inhomogeneous signal intensities suggestive of edema, angioma and scar were observed on MR scans taken one month after surgery. Disappearance of these signal intensities and decompression of the dural canal were observed with time, corresponding to the degree of clinical improvement. Antero-posterior diameter of the dural canal and the sectional area reflecting repair of the dural canal were increased. Sequential MR scanning with time may be helpful in evaluating the postoperative condition of intervertebral disc and the root of a spinal nerve. (N.K.).

  13. Changes of signal intensity on precontrast magnetic resonance imaging in spontaneously regressed lumbar disc herniation

    Energy Technology Data Exchange (ETDEWEB)

    Okushima, Yuichiro; Chiba, Kazuhiro; Matsumoto, Morio; Maruiwa, Hirofumi; Nishizawa, Takashi; Toyama, Yoshiaki [Keio Univ., Tokyo (Japan). School of Medicine

    2001-04-01

    To see whether the MRI images can give a criterion for conservative therapy of the lumbar disc herniation, time changes of the images were retrospectively studied on 41 cases of spontaneous regression. They had the imaging diagnosis 3 times in average until regression with GE Signa equipment (1.5T). Images were evaluated by 2 experts. Certain cases accompanying the brightness change were seen during the process of regression. The period leading to the disappearance of melosalgia and to the regression tended to be short in cases with the brighter pulp center than disc and/or with less bright pulp verge than center. Further studies were thought necessary for clear conclusion. (K.H.)

  14. Lumbar disc herniation and cauda equina syndrome following spinal manipulative therapy: a review of six court decisions in Canada.

    Science.gov (United States)

    Boucher, Pierre; Robidoux, Sébastien

    2014-02-01

    The purpose of this review is to expand practitioners' knowledge on areas of liability when treating low back pain patients. Six cases where chiropractors in Canada were sued for allegedly causing or aggravating lumbar disc herniation after spinal manipulative therapy were retrieved using the CANLII search database. The case series involves 4 men and 2 women with an average age of 37.3 years (range, 31-48 years). Trial courts' decisions were rendered between 2000 and 2011. This study highlights the following conclusions from Canadian courts: 1) informed consent is an ongoing process that cannot be entirely delegated to office personnel; 2) when the patient's history reveals risk factors for lumbar disc herniation the chiropractor has the duty to rule out disc pathology as an etiology for the symptoms presented by the patients before beginning anything but conservative palliative treatment; 3) lumbar disc herniation may be triggered by spinal manipulative therapy on vertebral segments distant from the involved herniated disc such as the thoracic spine.

  15. Discover cervical disc arthroplasty versus anterior cervical discectomy and fusion in symptomatic cervical disc diseases: A meta-analysis

    Science.gov (United States)

    Shangguan, Lei; Ning, Guang-Zhi; Tang, Yu; Wang, Zhe; Luo, Zhuo-Jing; Zhou, Yue

    2017-01-01

    Objective Symptomatic cervical disc disease (SCDD) is a common degenerative disease, and Discover artificial cervical disc, a new-generation nonconstrained artificial disk, has been developed and performed gradually to treat it. We performed this meta-analysis to compare the efficacy and safety between Discover cervical disc arthroplasty (DCDA) and anterior cervical discectomy and fusion (ACDF) for SCDD. Methods An exhaustive literature search of PubMed, EMBASE, and the Cochrane Library was conducted to identify randomized controlled trials that compared DCDA with ACDF for patients suffering SCDD. A random-effect model was used. Results were reported as standardized mean difference or risk ratio with 95% confidence interval. Results Of 33 articles identified, six studies were included. Compared with ACDF, DCDA demonstrated shorter operation time (P 0.05). Subgroup analyses did not demonstrated significant differences. Conclusion In conclusion, DCDA presented shorter operation time, and better ROM at the operative level. However, no significant differences were observed in blood loss, NDI scores, neck and arm pain scores, JOA scores, secondary surgery procedures and adverse events between the two groups. Additionally, more studies of high quality with mid- to long-term follow-up are required in future. PMID:28358860

  16. 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.

  17. 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.

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

    Science.gov (United States)

    Kose, Kamil Cagri; Altinel, Levent; Isikb, Cengiz; Komurcuc, Erkam; Mutlud, Serhat; Ozdemire, Mustafa

    2009-10-10

    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.

  19. 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.

  20. Sacroiliac joint dysfunction in patients with imaging-proven lumbar disc herniation.

    Science.gov (United States)

    Galm, R; Fröhling, M; Rittmeister, M; Schmitt, E

    1998-01-01

    A dysfunction of a joint is defined as a reversible functional restriction of motion presenting with hypomobility according to manual medicine terminology. The aim of our study was to evaluate the frequency and significance of sacroiliac joint (SIJ) dysfunction in patients with low back pain and sciatica and imaging-proven disc herniation. We examined the SIJs of 150 patients with low back pain and sciatica; all of these patients had herniated lumbar disks, but none of them had sensory or motor losses. Forty-six patients, hereinafter referred to as group A, were diagnosed with dysfunction of the SIJ. The remaining 104 patients, hereinafter referred to as group B, had no SIJ dysfunction. Dysfunctions were resolved with mobilizing and manipulative techniques of manual medicine. Regardless of SIJ findings, all patients received intensive physiotherapy throughout a 3-week hospitalisation. At the 3 weeks follow-up, 34 patients of group A (73.9%) reported an improvement of lumbar and ischiadic pain, 5 patients were pain free. Improvement was recorded in 57 of the group B patients (54.8%); however, nobody in group B was free of symptoms. We conclude that in the presence of lumbar and ischiadic symptoms our presented data suggest consideration of SIJ dysfunction, requiring manual medicine examination and, in the presence of SIJ dysfunction, appropriate therapy, regardless of intervertebral disc pathomorphology. This could avoid wrong indications for nucleotomy.

  1. 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

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

    OpenAIRE

    Koes Bart W; Arts Mark P; Brand Ronald; Peul Wilco C; Brouwer Patrick A; Berg Annette; van Buchem Mark A

    2009-01-01

    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...

  3. Describing a new syndrome in L5-S1 disc herniation: Sexual and sphincter dysfunction without pain and muscle weakness

    Directory of Open Access Journals (Sweden)

    Nezih Akca

    2014-01-01

    Full Text Available Context: Little seems to be known about the sexual dysfunction (SD in lumbar intervertebral disc herniation. Aims: Investigation of sexual and sphincter dysfunction in patient with lumbar disc hernitions. Settings and Design: A retrospective analysis. Materials and Methods: Sexual and sphincter dysfunction in patients admitted with lumbar disc herniations between September 2012-March 2014. Statistical Analysis Used: Statistical analysis was performed using the Predictive Analytics SoftWare (PASW Statistics 18.0 for Windows (Statistical Package for the Social Sciences, SPSS Inc., Chicago, Illinois. The statistical significance was set at P < 0.05. The Wilcoxon signed ranks test was used to evaluate the difference between patients. Results: Four patients with sexual and sphincter dysfunction were found, including two women and two men, aged between 20 and 52 years. All of them admitted without low back pain. In addition, on neurological examination, reflex and motor deficit were not found. However, almost all patients had perianal sensory deficit and sexual and sphincter dysfunction. Magnetic resonance imaging (MRI of three patients displayed a large extruded disc fragment at L5-S1 level on the left side. In fourth patient, there were not prominent disc herniations. There was not statistically significant difference between pre-operative and post-operative sexual function, anal-urethral sphincter function, and perianal sensation score. A syndrome in L5-S1 disc herniation with sexual and sphincter dysfunction without pain and muscle weakness was noted. We think that it is crucial for neurosurgeons to early realise that paralysis of the sphincter and sexual dysfunction are possible in patients with lumbar L5-S1 disc disease. Conclusion: A syndrome with perianal sensory deficit, paralysis of the sphincter, and sexual dysfunction may occur in patients with lumbar L5-S1 disc disease. The improvement of perianal sensory deficit after surgery was

  4. Heterotopic ossification associated with myelopathy following cervical disc prosthesis implantation.

    Science.gov (United States)

    Wenger, Markus; Markwalder, Thomas-Marc

    2016-04-01

    This case report presents a 37-year-old man with clinical signs of myelopathy almost 9 years after implantation of a Bryan disc prosthesis (Medtronic Sofamor Danek, Memphis, TN, USA) for C5/C6 soft disc herniation. As demonstrated on MRI and CT scan, spinal cord compression was caused by bony spurs due to heterotopic ossification posterior to the still moving prosthesis. The device, as well as the ectopic bone deposits, had to be removed because of myelopathy and its imminent aggravation. Conversion to anterior spondylodesis was performed.

  5. Physical examination for lumbar radiculopathy due to disc herniation in patients with low-back pain (Review)

    NARCIS (Netherlands)

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

    2011-01-01

    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

  6. Diagnostic value of history and physical examination in patients suspected of sciatica due to disc herniation : a systematic review

    NARCIS (Netherlands)

    Vroomen, PCAJ; de Krom, MCTFM; Knottnerus, JA

    1999-01-01

    We conducted a systematic review of the literature from 1965-1994 to assess the value of history and physical examination in the diagnosis of sciatica due to disc herniation; we also included population characteristics and features of the study design affecting diagnostic value. Studies on the diagn

  7. 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

    ) in vertebrae are observed in 6 % of the general population and in 35-40 % of people with low back pain. These changes are strongly associated with low back pain. There are probably a mechanical cause and an infective cause that causes MC. Several studies on nuclear tissue from herniated discs have demonstrated...

  8. Foraminal deposition of calcium pyrophosphate dihydrate crystals in the thoracic spine: possible relationship with disc herniation and implications for surgical planning. Report of two cases.

    Science.gov (United States)

    Paolini, Sergio; Ciappetta, Pasquale; Guiducci, Antonio; Principi, Massimo; Missori, Paolo; Delfini, Roberto

    2005-01-01

    The authors report two cases of nodular calcium pyrophosphate dihydrate (CPPD) crystal deposition close to the thoracic neural foramen, which caused chronic radiculopathy. Preoperatively, the lesions were interpreted as calcified disc herniations. Both patients underwent surgery in which an extended transfacet pedicle-sparing approach was used. Incision of the posterior longitudinal ligament released soft degenerated material. In both cases, histological examination showed abundant degenerative debris along with CPPD crystals. Spinal CPPD deposition is a comparatively rare disease that almost invariably involves the posterior aspect of the spinal canal, typically the ligamentum flavum. The exceptional foraminal location of the lesions reported here, combined with the surgical findings, indicated that the CPPD crystals were deposited on a laterally herniated disc fragment. A distinctive feature in both cases was the soft consistency of the resected tissue. The consistency of the disc material and the location of the lesion in the axial plane (that is, median compared with lateral) are key factors in determining the optimal surgical approach to thoracic disc herniations. In describing consistency, terms such as "calcified" and "hard" have been used interchangeably in the literature. In the cases reported here, what appeared on computerized tomography and magnetic resonance imaging studies to be densely calcified lesions were shown intraoperatively to be soft herniations. The authors' experience underscores that not all densely calcified herniated discs are hard. Although detection of this discrepancy would have left surgical planning for the lateral disc herniations unchanged, it could have altered planning for centrally or centrolaterally located disc herniations.

  9. The Long-term Efficacy and Safety of Percutaneous Cervical Nucleoplasty in Patients with a Contained Herniated Disk

    NARCIS (Netherlands)

    Halim, W.; Wullems, J.A.; Lim, T.; Aukes, H.A.; Weegen, W. van der; Vissers, K.C.P.; Gultuna, I.; Chua, N.H.

    2013-01-01

    BACKGROUND: Percutaneous cervical nucleoplasty (PCN) is a safe and effective treatment in symptomatic patients with contained cervical herniated disks. It provides simple and efficient disk decompression, using a controlled and highly localized ablation, but evidence regarding long-term efficacy is

  10. 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.

  11. 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.

  12. THORACIC DISC HERNIATION: SURGICAL DECOMPRESSION BY POSTERIOR APPROACH A LA CARTE

    Directory of Open Access Journals (Sweden)

    MURILO TAVARES DAHER

    Full Text Available ABSTRACT Objectives: To present the clinical and radiographic results of patients with thoracic disc herniation treated by the posterior approach, according to location and type of hernia (à la carte. Methods: We evaluated thirteen patients (14 hernias treated by the posterior approach. Eight (61.5% patients were male and the mean age was 53 years (34-81. Clinical evaluation was performed by the Frankel and JOA modified scales. All the patients underwent the posterior approach, which was performed by facetectomy, transpedicular approach, transpedicular + partial body resection, costotransversectomy or costotransversectomy + reconstruction with CAGE. Results: The mean follow-up was 2 years and 6 months (11-77 months. Of the 14 operated hernias, six (43% were lateral, 2 (14% paramedian, and 6 (43% central. Seven were soft (50% and seven were calcified. The transfacet approach was carried out in 5 cases (36%, transpedicular in 1 case (7%, transpedicular + partial body resection in 4 (29%, costotransversectomy in 3 (21%, and costotransversectomy + CAGE in one case (7%. The majority of patients with lateral hernia (5/6 were subjected to transfacet decompression and in cases of central and paramedian hernias, all patients underwent decompression, which is more extensive. Conclusions: The posterior approach is safe and effective, and the best approach must be chosen based on location and type of the herniation and the surgeon's experience.

  13. 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...... pain and disability is unacceptable, surgical intervention provides effective clinical relief in many cases. Currently there is little consensus in the medical community on the timing of surgery for patients suffering from radicular pain due to LDH. Reports based on the SPORT database indicate...... that prolonged symptom-duration correlates with inferior outcome. Purpose / Aim of Study: The aim of this study is to evaluate if prolonged symptom-duration is correlated with less favorable outcome following surgery for LDH in a Single- Center Study. Materials and Methods: 832 patients with first-time LDH were...

  14. Surgical Outcome of Two-Level Transforaminal Percutaneous Endoscopic Lumbar Discectomy for Far-Migrated Disc Herniation

    Science.gov (United States)

    Wu, Xinbo; Fan, Guoxin; Gu, Xin

    2016-01-01

    Objective. To describe the two-level percutaneous endoscopic lumbar discectomy (PELD) technique in transforaminal approach for highly migrated disc herniation and investigate its clinical outcomes. Methods. A total of 22 consecutive patients with highly migrated lumbar disc herniation were enrolled for the study from June 2012 to February 2014. Results. There were 12 males and 10 females, with a mean age of 41.1 (range 23–67) years. The mean follow-up period was 18.05 (range 14–33) months. According to the modified MacNab criteria, the clinical outcome at the final follow-up was excellent in 14, good in 6, and fair in 2 patients and the satisfactory rate (excellent and good) was 90.9%. The improvements in VAS and ODI were statistically significant. One patient had recurrent herniation in 18 months after the first surgery and underwent open discectomy. One patient showed symptoms of postoperative dysesthesia (POD), but the POD symptom was transient and partial remission was achieved in two months after conservative treatment. Conclusion. Two-level PELD in transforaminal approach can be a safe and effective procedure for highly migrated disc herniation. PMID:28070509

  15. The surgery and early postoperative radicular pain in cases with multifocal lumbar disc herniation

    Science.gov (United States)

    Ulutaş, Murat; Çınar, Kadir; Seçer, Mehmet

    2017-01-01

    Abstract Persistence of postoperative radicular pain after surgery for multifocal disc herniation (MFDH) is a clinical problem. This study aims to evaluate the effects of a combined treatment approach compared with unilateral stabilization on early postoperative radicular pain in patients with MFDH. Age, sex, level of operation, clinical findings, and radicular pain visual analogue scale (VAS) scores before surgery in the early postoperative period and at 3 months after surgery were retrospectively reviewed for 20 cases of multifocal lumbar disc herniation. The combined approach (translaminar and far lateral) was used for 13 cases. Seven cases underwent transforaminal lumbar interbody fusion (TLIF) and unilateral transpedicular stabilization following total facetectomy. The mean age of the sample was 49.4 ± 10.1 years and the female-to-male ratio was 8:12. The mean VAS scores for radicular pain in cases treated with the combined approach were 8.2, 4.07, and 2.3 in the preoperative and early postoperative periods and 3 months after surgery, respectively. The mean score for radicular pain improved by 50.4% in the early postoperative period and by 72% in the late postoperative period. The mean VAS scores for radicular pain in cases who underwent TLIF and unilateral stabilization after facetectomy were 8.4, 2.1, and 1.4 in the preoperative and early postoperative periods and 3 months after surgery, respectively. The mean VAS score for radicular pain improved by 75% in the early postoperative period and by 83.3% in the late postoperative period. The combined approach is an effective alternative in cases with MFDH. TLIF and unilateral segmental stabilization provide substantial decompression and eliminate mechanical compression by conserving the height of the intervertebral foramen in the event that sufficient decompression is unable to obtain. We suggest that elimination of chemical mediators, particularly those causing pain in the dorsal ganglion, contributes to

  16. Serum Levels of the Inflammatory Cytokines in Patients with Lumbar Radicular Pain Due to Disc Herniation

    Science.gov (United States)

    Zu, Bo; Pan, Hong; Zhang, Xiao-Jun

    2016-01-01

    Study Design Cohort study. Purpose This study primarily aimed to evaluate the serum levels of tumor necrosis factor-alpha (TNF-α) and interleukin (IL)-4 in patients with lumbar radiculopathy 1 and 12 months after microdiscectomy. Overview of Literature Lumbar radiculopathy is possibly caused by inflammatory changes in the nerve root. The intraneural application of pro-inflammatory cytokines induces behavioral signs associated with pain. Anti-inflammatory cytokine treatment effectively reduces hyperalgesia. Methods The role of TNF-α and IL-4 in long-lasting lumbar radiculopathy was addressed. A total of 262 patients were recruited from Anqing Hospital, Anhui Medical University. During inclusion at 1 and 12 months, serum concentrations of TNF-α and IL-4 were analyzed by enzyme-linked immunosorbent assay, and pain intensity was reported on a 0–10 cm visual analog scale (VAS). Results Sixty six patients had VAS <3 and 196 patients had VAS ≥3. Serum concentrations of pro-inflammatory TNF-α and anti-inflammatory IL-4 in patients with lumbar radiculopathy related to disc herniation were measured at 1- and 12-month follow-up. TNF-α decreased in both VAS groups with time. In contrast, IL-4 increased in both groups at 1 month and then decreased gradually until month 12. The changes in serum levels of TNF-α and IL-4 over time between the VAS ≥3 and VAS <3 groups were significantly different. Conclusions Chronic lumbar radiculopathy may be associated with high level of pro-inflammatory substances, such as TNF-α, in serum after disc herniation, and elevated anti-inflammatory cytokine in patients with lumbar radiculopathy may indicate a favorable outcome. PMID:27790311

  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. 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.

  19. 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.

  20. Cerebrospinal fluid tau protein as a biomarker for severity of spinal cord injury in dogs with intervertebral disc herniation.

    Science.gov (United States)

    Roerig, A; Carlson, R; Tipold, A; Stein, V M

    2013-08-01

    Intervertebral disc herniation (IVDH) is a common cause of spinal cord injury (SCI) in dogs. Microtubule-associated protein tau derives predominantly from neurons and axons, making it a potential marker of neuronal injury. A retrospective study, including 51 dogs with thoracolumbar or cervical IVDH and 12 clinically normal dogs, was designed to describe associations between cerebrospinal fluid (CSF) tau concentration, degree of neurological signs and motor functional recovery in dogs with IVDH. Signalment, degree of neurological dysfunction and outcome were recorded. Cisternal CSF tau values were determined by ELISA. Associations between CSF tau concentration and various clinical parameters were evaluated. Receiver-operating characteristics curve (ROC) analyses were performed to assess the validity of protein tau measurements. CSF tau concentrations were significantly higher in dogs showing plegia (median, 79.9 pg/mL; range, 0-778.7 pg/mL; P=0.016) compared to healthy dogs and dogs with paresis (median, 30.1 pg/mL; range, 0-193.1 pg/mL; P=0.025). Plegic dogs that improved by one neurological grade within 1 week had significantly lower tau protein levels compared to plegic dogs that needed more time for recovery or did not show an improvement (P=0.008). A CSF tau concentration >41.3 pg/mL had a sensitivity of 86% and specificity of 83% to predict an unsuccessful outcome in plegic dogs based on ROC analysis (area under the curve, 0.887; P=0.007, 95% confidence interval [CI] 0.717-1.057). CSF protein tau levels are positively associated with the severity of spinal cord damage and may serve as a prognostic indicator in dogs with IVDH.

  1. 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

  2. Operative management of lumbar disc herniation : the evolution of knowledge and surgical techniques in the last century.

    Science.gov (United States)

    Postacchini, F; Postacchini, R

    2011-01-01

    Removal of a herniated disc with the use of the operative microscope was first performed by Yasargil (Adv Neurosurg. 4:81-2, 1977) in 1977. However, it began to be used more and more only in the late 1980s (McCulloch JA (1989) Principles of microsurgery for lumbar disc disease. Raven Press, New York). In the 1990s, many spinal surgeons abandoned conventional discectomy with naked-eye to pass to the routine practice of microdiscectomy. The merits of this technique are that it allows every type of disc herniation to be excised through a short approach to skin, fascia and muscles as well as a limited laminoarthrectomy. For these reasons, it has been, and still is, considered the "gold standard" of surgical treatment for lumbar disc herniation, and the method used by the vast majority of spinal surgeons. In the 1990s, the advent of MRI and the progressive increase in definition of this modality of imaging, as well as histopathologic and immunochemical studies of disc tissue and the analysis of the results of conservative treatments have considerably contributed to the knowledge of the natural evolution of a herniated disc. It was shown that disc herniation may decrease in size or disappear in a few weeks or months. Since the second half of the 1990s there has been a revival of percutaneous procedures. Some of these are similar to the percutaneous automated nucleotomy; other methods are represented by intradiscal injection of a mixture of "oxygen-ozone" (Alexandre A, Buric J, Paradiso R. et al. (2001) Intradiscal injection of oxygen ozone for the treatment of lumbar disc herniations: result at 5 years. 12th World Congress of Neurosurgery; 284-7), or laserdiscectomy performed under CT scan (Menchetti PPM. (2006) Laser Med Sci. 4:25-7). The really emerging procedure is that using an endoscope inserted into the disc through the intervertebral foramen to visualize the herniation and remove it manually using thin pituitary rongeurs, a radiofrequency probe or both (Chiu JC

  3. Risk of small field of view in lumbar spine computed tomography for assumed lumbar disc herniation: beware contained aortic aneurysm

    Energy Technology Data Exchange (ETDEWEB)

    Marsman, J.W.P. [Gooi-Noord Hospital, Blaricum (Netherlands). Dept. of Radiology

    1995-05-01

    Among several other atypical clinical presentations, back and leg pain may ensue from a contained ruptured abdominal aortic aneurysm. The present case concerns a patient whose back and leg pain were primarily thought to be orthopaedic or neurologic in origin. Computed tomography with small field of view, performed for the detection of a possible lumbar disc herniation, only partially showed a paraspinal soft tissue mass. Subsequently, recognition of this mass as a contained ruptured aortic aneurysm was delayed. The literature is reviewed concerning comparable cases and it is concluded that computed tomograms performed for possible lumbar disc herniation should also be screened for paraspinal disease and consequently, the applied field of view should be large enough to include at least the paraspinal psoas regions. 25 refs., 1 tab., 2 figs.

  4. 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

  5. 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

  6. Fluoroscopic caudal epidural injections in managing chronic axial low back pain without disc herniation, radiculitis, or facet joint pain

    OpenAIRE

    Manchikanti L; Cash KA; McManus CD; Pampati V

    2012-01-01

    Laxmaiah Manchikanti,1,2 Kimberly A Cash,1 Carla D McManus,1 Vidyasagar Pampati11Pain Management Center of Paducah, Paducah, 2Department of Anesthesiology and Perioperative Medicine, University of Louisville, Louisville, KY, USABackground: Chronic low back pain without disc herniation is common. Various modalities of treatments are utilized in managing this condition, including epidural injections. However, there is continued debate on the effectiveness, indications, and medical necessity of ...

  7. The effect of age on result of straight leg raising test in patients suffering lumbar disc herniation and sciatica

    OpenAIRE

    2015-01-01

    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 M...

  8. Lumbar extension exercises in conjunction with mechanical traction for the management of a patient with a lumbar herniated disc.

    Science.gov (United States)

    Gagne, Allison R; Hasson, Scott M

    2010-05-01

    Low back pain resulting from lumbar disc herniation is a common reason for referral for physical therapy. There is no evidence to support the management of lumbar disc herniation and derangement using mechanical traction combined with lumbar extension exercises. Therefore, the purpose of this case report was to describe and discuss the use of mechanical traction in conjunction with lumbar extension exercises for a patient with a lumbar herniated disc. The patient was a 49-year-old male referred to physical therapy with a medical diagnosis of a lumbar herniated disc at L5-S1 with compression of the L5 nerve root confirmed by MRI. The patient's chief complaint was pain over the left lumbosacral and central lumbar region with radiating pain into the left buttock accompanied by numbness and tingling in the left lower leg and foot. The patient was seen for a total of 14 visits. The first 5 days (2 weeks) of therapy consisted of lumbar extension exercises. For the following nine visits (over a 3-week period), mechanical traction was added as an adjunct to the extension exercises. Outcome measures included the Oswestry Disability Questionnaire, Back Pain Function Scale (BPFS), and the Numeric Pain Rating Scale (NPRS). Results from initial evaluation to discharge (Oswestry: 36% to 0%; BPFS: 33/60 to 57/60; NPRS: 7/10 to 0/10) demonstrated that the patient no longer experienced low back pain and improved in terms of functional status and pain-related disability. The patient no longer complained of numbness and tingling in the left lower extremity and the goals for the patient had been attained. The data from this case report suggests lumbar extension exercises in conjunction with mechanical traction facilitated the patient's improvement in pain and return to prior level of function.

  9. Fluoroscopic caudal epidural injections in managing chronic axial low back pain without disc herniation, radiculitis, or facet joint pain

    Directory of Open Access Journals (Sweden)

    Manchikanti L

    2012-10-01

    Full Text Available Laxmaiah Manchikanti,1,2 Kimberly A Cash,1 Carla D McManus,1 Vidyasagar Pampati11Pain Management Center of Paducah, Paducah, 2Department of Anesthesiology and Perioperative Medicine, University of Louisville, Louisville, KY, USABackground: Chronic low back pain without disc herniation is common. Various modalities of treatments are utilized in managing this condition, including epidural injections. However, there is continued debate on the effectiveness, indications, and medical necessity of any treatment modality utilized for managing axial or discogenic pain, including epidural injections.Methods: A randomized, double-blind, actively controlled trial was conducted. The objective was to evaluate the ability to assess the effectiveness of caudal epidural injections of local anesthetic with or without steroids for managing chronic low back pain not caused by disc herniation, radiculitis, facet joints, or sacroiliac joints. A total of 120 patients were randomized to two groups; one group did not receive steroids (group 1 and the other group did (group 2. There were 60 patients in each group. The primary outcome measure was at least 50% improvement in Numeric Rating Scale and Oswestry Disability Index. Secondary outcome measures were employment status and opioid intake. These measures were assessed at 3, 6, 12, 18, and 24 months after treatment.Results: Significant pain relief and functional status improvement (primary outcome defined as a 50% or more reduction in scores from baseline, were observed in 54% of patients in group 1 and 60% of patients in group 2 at 24 months. In contrast, 84% of patients in group 1 and 73% in group 2 saw significant pain relief and functional status improvement in the successful groups at 24 months.Conclusion: Caudal epidural injections of local anesthetic with or without steroids are effective in patients with chronic axial low back pain of discogenic origin without facet joint pain, disc herniation, and

  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. Comparison of percutaneous endoscopic lumbar discectomy and open lumbar surgery for adjacent segment degeneration and recurrent disc herniation.

    Science.gov (United States)

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

    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 herniation at L3-4, L4-5, or L5-S1 level, were assigned to different groups according to the surgical approaches. Clinical data were assessed and compared. Results. Mean blood loss was significantly less in the PELD group as compared to the open lumbar surgery group (P < 0.0001). Hospital stay and mean operating time were shorter significantly in the PELD group as compared to the open lumbar surgery group (P < 0.0001). Immediate postoperative pain improvement in VAS was 3.5 in the PELD group and -0.56 in the open lumbar surgery group (P < 0.0001). Conclusion. For ASD and recurrent lumbar disc herniation, PELD had more advantages over open lumbar surgery in terms of reduced blood loss, shorter hospital stay, operating time, fewer complications, and less postoperative discomfort.

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

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    Huan-Chieh Chen

    2015-01-01

    Full Text Available 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 herniation at L3-4, L4-5, or L5-S1 level, were assigned to different groups according to the surgical approaches. Clinical data were assessed and compared. Results. Mean blood loss was significantly less in the PELD group as compared to the open lumbar surgery group P<0.0001. Hospital stay and mean operating time were shorter significantly in the PELD group as compared to the open lumbar surgery group P<0.0001. Immediate postoperative pain improvement in VAS was 3.5 in the PELD group and −0.56 in the open lumbar surgery group P<0.0001. Conclusion. For ASD and recurrent lumbar disc herniation, PELD had more advantages over open lumbar surgery in terms of reduced blood loss, shorter hospital stay, operating time, fewer complications, and less postoperative discomfort.

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

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    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.

  14. Postural control in patients with lumbar disc herniation in the early postoperative period.

    Science.gov (United States)

    Sipko, Tomasz; Chantsoulis, Marzena; Kuczyński, Michał

    2010-03-01

    Chronic spinal disc disease leads to disorders in postural movement coordination. An incorrect asymmetrical movement pattern for the lower limbs loading impairs proprioception and deteriorates postural stability, particularly when the vision is occluded. The standard surgical treatment improves biomechanical conditions in the lumbar spine, reduces pain, yet does it reduce the stability deficit in the upright position? An answer to the latter question would help work out targeted therapy to improve postural stability. We hypothesized that the standard surgical treatment would improve postural stability reflected by decreased sway variability accounting for better use of proprioceptive inputs postoperatively. Thirty-nine patients with lumbar disc herniation participated in the study. Their postural sway was recorded in anterior/posterior and medial/lateral planes with their eyes open or closed (EC) before and after surgery. The variability, range, mean velocity of the recorded time series and the area of the ellipse enclosed by the statokinesiogram were used as measures of postural stability. Preoperatively, EC condition resulted in an increased variability and mean velocity of postural sway, while postoperatively it caused an increase in sway mean velocity and sway area only with no effect on sway variability and range. The comparison of the balance before and after the surgery in the EC condition showed significant decrease in all parameters. In the early postoperative period, the patients recover the ability to control their postural sway in EC within normal limits, however, at the expense of significantly increased frequency of corrective torques. It is probably a transient short-term strategy needed to compensate for the recovery phase when the normal weighting factors for all afferents are being reestablished. We propose that this transient postoperative period may be the best timing of therapeutic intervention targeted at facilitating and reinforcing the

  15. Combined intra-extracanal approach to lumbosacral disc herniations with bi-radicular involvement. Technical considerations from a surgical series of 15 cases.

    Science.gov (United States)

    Paolini, Sergio; Ciappetta, Pasquale; Raco, Antonino; Missori, Paolo; Delfini, Roberto

    2006-05-01

    Large lumbosacral disc herniations effacing both the paramedian and the foraminal area often cause double radicular compression. Surgical management of these lesions may be difficult. A traditional interlaminar approach usually brings into view only the paramedian portion of the intervertebral disc, unless the lateral bone removal is considerably increased. Conversely, the numerous far-lateral approaches proposed for removing foraminal or extraforaminal disc herniations would decompress the exiting nerve root only. Overall, these approaches share the drawback of controlling the neuroforamen on one side alone. A combined intra-extraforaminal exposure is a useful yet rarely reported approach. Over a 3-year period, 15 patients with bi-radicular symptoms due to large disc herniations of the lumbar spine underwent surgery through a combined intra-extracanal approach. A standard medial exposure with an almost complete hemilaminectomy of the upper vertebra was combined with an extraforaminal exposure, achieved by minimal drilling of the inferior facet joint, the lateral border of the pars interarticularis and the inferior margin of the superior transverse process. The herniated discs were removed using key maneuvers made feasible by working simultaneously on both operative windows. In all cases the disc herniation could be completely removed, thus decompressing both nerve roots. Radicular pain was fully relieved without procedure-related morbidity. The intra-extraforaminal exposure was particularly useful in identifying the extraforaminal nerve root early. Early identification was especially advantageous when periradicular scar tissue hid the nerve root from view, as it did in patients who had undergone previous surgery at the same site or had long-standing radicular symptoms. Controlling the foramen on both sides also reduced the risk of leaving residual disc fragments. A curved probe was used to push the disc material outside the foramen. In conclusion, specific

  16. 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 ...

  17. 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

  18. [Traumatic cervical disc prolapse with severe neurological impact].

    Science.gov (United States)

    Knudsen, Roland; Gundtoft, Per

    2014-12-15

    A 51-year-old male drove into a ditch on his scooter. Immediately after the trauma the patient complained of neck pain and decreased ability to feel and move his extremities. An initial trauma computed tomography (CT) of the columna showed normal conditions. Because the patient had neurological deficiencies, magnetic resonance imaging of the columna was performed 12 days later, and a disc prolapse at the C3/C4 level with spinal cord compression was visible. Despite decompression the patient did not recover. Traumatic cervical disc prolapse is a rare and positionally dangerous condition, which can be present despite a CT showing normal conditions.

  19. Two-level cervical disc replacement: perspectives and patient selection

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    Narain AS

    2017-02-01

    Full Text Available Ankur S Narain, Fady Y Hijji, Daniel D Bohl, Kelly H Yom, Krishna T Kudaravalli, Kern Singh Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA Introduction: Cervical disc replacement (CDR is an emerging treatment option for cervical degenerative disease. Postulated benefits of cervical disc replacement compared to anterior cervical discectomy and fusion include preserved motion at the operative segments and decreased motion at adjacent levels. Multiple studies have been performed investigating the outcomes of CDR in single-level pathology. The investigation of the use of CDR in two-level pathology is an emerging topic within the literature.Purpose: To critically evaluate the literature regarding two-level CDR in order to determine its utility compared to two-level cervical arthrodesis. Patient selection factors including indications and contraindications will also be explored.Methods: The PubMed database was searched for all articles published on the subject of two-level CDR up until October 2016. Studies were classified by publication year, study design, sample size, follow-up interval, and conflict of interest. Outcomes were recorded from each study, and included data on patient-reported outcomes, radiographic measurements, range of motion, peri- and postoperative complications, heterotopic ossification, adjacent segment disease, reoperation rate, and total intervention cost. Results: Fourteen studies were included in this review. All studies demonstrated at least noninferiority of two-level CDR compared to both two-level arthrodesis and single-level CDR. Patient selection in two-level CDR is driven by the inclusion and exclusion criteria presented in prospective, randomized controlled trials. The most common indication is subaxial degenerative disc disease over two contiguous levels presenting with radiculopathy or myelopathy. Furthermore, costs analyses trended toward at least noninferiority of two

  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)

    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 morphological changes in the related structures. In order to better understand the relationships, we investigated the following objectives. 1) the changes of LDH size through quantitative measures from MRI images taken at three time points over an eight-year period, 2) the cross-sectional associations between...... 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...

  1. Adjacent segment degeneration after single-level anterior cervical decompression and fusion: disc space distraction and its impact on clinical outcomes.

    Science.gov (United States)

    Li, Jia; Li, Yongqian; Kong, Fanlong; Zhang, Di; Zhang, Yingze; Shen, Yong

    2015-03-01

    The purpose of this study was to find whether excessive distraction of the disc space for cage insertion was a risk factor for adjacent segment degeneration (ASD) after anterior cervical decompression and fusion (ACDF). One hundred and sixteen consecutive patients who underwent ACDF for single-level cervical disc herniation between June 2006 and November 2008 were retrospectively reviewed. Preoperative, postoperative and final follow-up disc height (DH), sagittal segmental alignment (SSA), and sagittal alignment of the cervical spine (SACS) were measured and compared between the ASD group and non-ASD group. In 116 patients, ASD was radiographically proven in 28 (24.1%) patients. The clinical outcomes were significantly improved compared to the preoperative scores in both groups. However, the postoperative and final follow-up DH of the ASD group were significantly higher than in the non-ASD group (p<0.05). In addition, the postoperative DH was significantly correlated with the postoperative or final follow-up SSA (p<0.05). However, postoperative DH was not found to significantly correlate with postoperative or final follow-up SACS (p=0.072 and p=0.096, respectively). Multivariate analysis showed that postoperative DH was the most significant risk factor for ASD. The clinical outcomes of ACDF for single-level degenerative cervical disc disease were satisfactory. Postoperative DH (the distracted distance) had the greatest impact on the incidence of ASD. Excessive disc space distraction is a considerable risk factor for the development of radiographic ASD.

  2. Gadolinium-DTPA enhanced MRI with CHESS method for lumbar disc herniation; Visualization of affected nerve roots

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    Aota, Yoichi; Kumano, Kiyoshi; Hirabayashi, Shigeru; Ogawa, Yutaka; Yoshikawa, Koki (Kanto Rosai Hospital, Kawasaki, Kanagawa (Japan))

    1993-11-01

    A total of 34 DTPA-enhanced magnetic resonance imaging (MRI) studies were made pre- and/or post-operatively by using chemical shift selective method in 31 patients with lumbar disc herniation. DTPA enhancement was seen in affected nerve roots in 7 of 15 preoperative cases and 6 of 12 postoperative cases with unfavorable course. When straight leg raising test revealed severe stimulation to the lower extremity nerve roots (less than 45degree), affected nerve roots were significantly enhanced with DTPA. All enhanced sites, except for one of arachnoid inflammation, was most remarkably compressed by herniation. Edema within the affected nerve root would be detected by DTPA-enhanced MRI. (N.K.).

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

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    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

  4. Nuclear factor-kappa B decoy suppresses nerve injury and improves mechanical allodynia and thermal hyperalgesia in a rat lumbar disc herniation model.

    Science.gov (United States)

    Suzuki, Munetaka; Inoue, Gen; Gemba, Takefumi; Watanabe, Tomoko; Ito, Toshinori; Koshi, Takana; Yamauchi, Kazuyo; Yamashita, Masaomi; Orita, Sumihisa; Eguchi, Yawara; Ochiai, Nobuyasu; Kishida, Shunji; Takaso, Masashi; Aoki, Yasuchika; Takahashi, Kazuhisa; Ohtori, Seiji

    2009-07-01

    Nuclear factor-kappa B (NF-kappaB) is a gene transcriptional regulator of inflammatory cytokines. We investigated the transduction efficiency of NF-kappaB decoy to dorsal root ganglion (DRG), as well as the decrease in nerve injury, mechanical allodynia, and thermal hyperalgesia in a rat lumbar disc herniation model. Forty rats were used in this study. NF-kappaB decoy-fluorescein isothiocyanate (FITC) was injected intrathecally at the L5 level in five rats, and its transduction efficiency into DRG measured. In another 30 rats, mechanical pressure was placed on the DRG at the L5 level and nucleus pulposus harvested from the rat coccygeal disc was transplanted on the DRG. Rats were classified into three groups of ten animals each: a herniation + decoy group, a herniation + oligo group, and a herniation only group. For behavioral testing, mechanical allodynia and thermal hyperalgesia were evaluated. In 15 of the herniation rats, their left L5 DRGs were resected, and the expression of activating transcription factor 3 (ATF-3) and calcitonin gene-related peptide (CGRP) was evaluated immunohistochemically compared to five controls. The total transduction efficiency of NF-kappaB decoy-FITC in DRG neurons was 10.8% in vivo. The expression of CGRP and ATF-3 was significantly lower in the herniation + decoy group than in the other herniation groups. Mechanical allodynia and thermal hyperalgesia were significantly suppressed in the herniation + decoy group. NF-kappaB decoy was transduced into DRGs in vivo. NF-kappaB decoy may be useful as a target for clarifying the mechanism of sciatica caused by lumbar disc herniation.

  5. 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

  6. 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.

  7. Lateral lumbar disc herniation: MR imaging findings and correlation with clinical symptoms

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    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.

  8. 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.

  9. 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.

  10. 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.

  11. 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

    STUDY DESIGN: We randomized 200 patients after lumbar discectomy to receive epidural steroid or none with a 2-year follow-up. OBJECTIVE: To evaluate the outcome, neurologic impairment and safety of epidural steroid following lumbar discectomy for herniated disc disease. SUMMARY OF BACKGROUND DATA......: 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 epidural steroid following lumbar discectomy. METHODS: Through 2001 and 2003 200 patients undergoing discectomy for herniated disc disease were randomly allocated to receive epidural methylprednisolone 40 mg or none. In the control group (62 males and 38 females, median age 41 years, 18-66) 48 L5, 50 L4...

  12. 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。

  13. 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.

  14. Durability of cervical disc arthroplasties and its influence factors

    Science.gov (United States)

    Chen, Chao; Zhang, Xiaolin; Ma, Xinlong

    2017-01-01

    Abstract Background: The durability of cervical disc arthroplasties (CDA) may vary significantly because of different designs and implanting techniques of the devices. Nevertheless, the comparative durability remains unknown. Objectives: We aimed to assess the durability of CDAs in at least 2-year follow-up. We analyzed the classifications and causes of secondary surgical procedures, as well as the structural designs of the devices that might influence the durability. Methods: PubMed, Medline, Embase, and Cochrane Central Register of Controlled Trials were searched from the inception of each database to September 2015 using the following Keywords: “cervical disc replacement” OR “cervical disc arthroplasty” AND “randomized controlled trial (RCT).” Publication language was restricted to English. The primary outcome was the rate of secondary surgical procedures following CDA or anterior cervical decompression and fusion (ACDF). Pairwise meta-analysis and a Bayesian network meta-analysis were carried out using Review Manager v5.3.5 and WinBUGS version 1.4.3, respectively. Quality of evidence was appraised by Grading of Recommendations Assessment, Development and Evaluation methodology. Results: Twelve RCTs that met the eligibility criteria were included. Follow-up ranged from 2 years to 7 years. A total of 103 secondary surgical procedures were performed. The most frequent classification of secondary surgical procedures was reoperation (48/103) and removal (47/103). Revision (3/103) and supplementary fixation (2/103) were rare. Adjacent-level diseases were the most common cause of reoperations. The rates of secondary surgical procedures were significantly lower in Mobi-C, Prestige, Prodisc-C, Secure-C group than in ACDF group. No significant difference was detected between Bryan, PCM, Kineflex-C, Discover, and ACDF. Mobi-C, Secure-C, and Prodisc-C ranked the best, the second best, the third best, respectively. Conclusions: We concluded that Mobi-C, Secure

  15. Percutaneous treatment of non-contained lumbar disc herniation by injection of oxygen-ozone combined with collagenase

    Energy Technology Data Exchange (ETDEWEB)

    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.

  16. 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....

  17. Overview on Treating Lumbar Disc Herniation by Acupuncture and Massage%针灸推拿治疗腰椎间盘突出症概况

    Institute of Scientific and Technical Information of China (English)

    范德辉; 曾姿霈; 刘建; 张振宁; 苏美意

    2013-01-01

    90%of lumbar disc herniation patients can be mitigated or cured through non-surgical therapy, while Chinese medicine for lumbar disc herniation plays an irreplaceable role in conservative treatments, at present, the comprehensive therapy like acupuncture, massage, traction, elec-troacupuncture for lumbar disc herniation all can achieve the satisfied efficacy. This article would review the research status of acupuncture and mas-sage for lumbar disc herniation.%90%的腰椎间盘突出症患者可通过非手术疗法得到缓解或治愈,而中医治疗腰椎间盘突出症在保守治疗方法中占有不可替代的重要作用,目前腰椎间盘突出症的治疗通过针灸、推拿、牵引、电针等综合治疗均能取得满意疗效。本文将就针灸推拿治疗腰椎间盘突出症的研究现况作一综述。

  18. 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

  19. 腰椎间盘突出症临床评估方法概述%Overview of Clinical Assessment of Lumbar Disc Herniation

    Institute of Scientific and Technical Information of China (English)

    闫继红; 韩琼; 代生成; 柳正伟; 李国武; 李庆兵; 罗建; 罗才贵

    2015-01-01

    Lumbar disc herniation is the clinically common and frequently-occurring disease, and shows a trend of younger, clinical evaluation of lumbar disc herniation is particularly important, this paper reviews the scale and test method evaluation of lumbar disc herniation and finds that detec-tion combination with clinical symptoms evaluation of lumbar disc herniation is most accurate and patients are more likely to accept, being condu-cive to establish the clinical treatment plan to evaluate the clinical efficacy.%腰椎间盘突出症是临床种常见病、多发病,并呈年轻化趋势,腰椎间盘突出症临床评估尤为重要,本文综述腰椎间盘突出症量表与检测方法评估,发现检测结合临床症状评估腰椎间盘突出症最准确且患者易接受,有利于确立临床治疗方案评价临床疗效。

  20. 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

  1. Parameters that effect spine biomechanics following cervical disc replacement.

    Science.gov (United States)

    Goel, Vijay K; Faizan, Ahmad; Palepu, Vivek; Bhattacharya, Sanghita

    2012-06-01

    Total disc replacement (TDR) is expected to provide a more physiologic alternative to fusion. However, long-term clinical data proving the efficacy of the implants is lacking. Limited clinical data suggest somewhat of a disagreement between the in vitro biomechanical studies and in vivo assessments. This conceptual paper presents the potential biomechanical challenges affecting the TDR that should be addressed with a hope to improve the clinical outcomes and our understanding of the devices. Appropriate literature and our own research findings comparing the biomechanics of different disc designs are presented to highlight the need for additional investigations. The biomechanical effects of various surgical procedures are analyzed, reiterating the importance of parameters like preserving uncinate processes, disc placement and its orientation within the cervical spine. Moreover, the need for a 360° dynamic system for disc recipients who may experience whiplash injuries is explored. Probabilistic studies as performed already in the lumbar spine may explore high risk combinations of different parameters and explain the differences between "standard" biomechanical investigations and clinical studies. Development of a patient specific optimized finite element model that takes muscle forces into consideration may help resolve the discrepancies between biomechanics of TDR and the clinical studies. Factors affecting long-term performance such as bone remodeling, subsidence, and wear are elaborated. In vivo assessment of segmental spine motion has been, and continues to be, a challenge. In general, clinical studies while reporting the data have placed lesser emphasis on kinematics following intervertebral disc replacements. Evaluation of in vivo kinematics following TDR to analyze the quality and quantity of motion using stereoradiogrammetric technique may be needed.

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

    Directory of Open Access Journals (Sweden)

    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.

  3. 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

  4. Cervical disc prosthesis: 2-year follow-up

    Directory of Open Access Journals (Sweden)

    Romero Pinto de Oliveira Bilhar

    2015-06-01

    Full Text Available OBJECTIVE: To review the medical records of patients who underwent surgery for placement of cervical disc prosthesis after two years of postoperative follow-up, showing the basic epidemiological data, the technical aspects and the incidence of complications.METHODS: Medical records of seven patients who underwent surgery for placement of cervical disc prosthesis were reviewed after two years of follow-up, at the Institute of Orthopedics and Traumatology, Faculty of Medicine, University of São Paulo.RESULTS: The average age of patients participating in this study was 43.86 years. Six patients (85.7% had one level approached while one patient (14.3% had two levels addressed. The level C5-C6 has been approached in one patient (14.3% while the C6-C7 level was addressed in five patients (71.4%. One patient (14.3% had these two levels being addressed, C5-C6 and C6-C7. The mean operative time was 164.29±40 minutes. Three patients were hospitalized for 2 days and four for 3 days making an average of 2.57±0.535 days. Two patients (28.6% underwent a new surgical intervention due to loosening of the prosthesis. The mean follow-up was 28.14±5.178 months (23-35 months.CONCLUSIONS: Although cervical arthroplasty appears to be a safe procedure and present promising results in our study as well as in many other studies, it requires long-term studies.

  5. Footprint Mismatch of Cervical Disc Prostheses with Chinese Cervical Anatomic Dimensions

    Institute of Scientific and Technical Information of China (English)

    Liang Dong; Ming-Sheng Tan; Qin-Hua Yan; Ping Yi; Feng Yang; Xiang-Sheng Tang; Qing-Ying Hao

    2015-01-01

    Background:The footprint of most prostheses is designed according to Caucasian data.Total disc replacement (TDR) has been performed widely for cervical degenerative diseases in China.It is essential to analyze the match sizes of prostheses footprints and Chinese cervical anatomic dimensions in our study.Methods:The anatomic dimensions of the C4-C7 segments of 138 patients (age range 16-77 years) in a Chinese population were measured by computed tomography scans.We compared the footprints of the most commonly used cervical disc prostheses (Bryan:Medtronic,Minneapolis,MN,USA; Prestige LP:Medtronic,Fridley,Minnesota,USA; Discover:DePuy,Raynham,MA,USA; Prodisc-C:Synthes,West Chester,PA,USA) in China with Chinese cervical anatomic dimensions and assessed the match of their size.Results:The mismatch of available dimensions of prostheses and anatomic data of cervical endplates ranged from 17.03% (C4/C5,Prestige LP,Prodisc-C) to 57.61% (C6/C7,Discover) in the anterior-posterior (AP) diameter,and 35.51% (C4/C5,Prodisc-C,Prestige LP) to 94.93% (C6/C7,Bryan) in the center mediolateral (CML) diameter.About 21.01% of endplates were larger than the largest prostheses in the AP diameter and 57.25% in the CML diameter.All available footprints of prostheses expect the Bryan with an unfixed height,can accommodate the disc height (DH),however,36.23% of the middle DH was less than the smallest height of the prostheses.The average disc sagittal angles (DSAs) of C4-C7 junctions were 5.04°,5.15°,and 4.13° respectively.Only the Discover brand had a built-in 7° lordotic angle,roughly matching with the DSA.Conclusions:There is a large discrepancy between footprints of prostheses and Chinese cervical anatomic data.In recent years,possible complications of TDR related with mismatch sizes are increasing,such as subsidence,displacement,and heterotopic ossification.Manufacturers of prostheses should introduce or produce additional footprints of prostheses for Chinese TDR.

  6. 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)

  7. 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.

  8. 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

  9. The nursing point for lumbar intervertebral disc herniation%腰椎间盘突出症护理要点

    Institute of Scientific and Technical Information of China (English)

    陈丽花

    2015-01-01

    Lumbar disc herniation (LDH) is also called fibrous ring rupture in lumbar spine. Because of the influence of lumbar degenerative changes or external force, lumbar intervertebral disc of internal and external pressure lose balance, then lead to lumber fibrous ring rupture and nucleus pulposus herniation, and press Lumbar nerve root, blood vessel, spinal cord, cauda equine. LDH is the common and frequently occurring disease of orthopedics. The main clinical symptoms are waist and leg pain and one side of the lower extremity radiating pain and numbness etc. LDH could occurr in all adults, mostly occur in middle-aged and old people, more men than women.%腰椎间盘突出症(Lumbar Dlac Hemiation,LDH)又称腰椎纤维环破裂症,是腰椎退行性改变或外力作用引起腰椎间盘内、外压力平衡失调所致腰椎纤维环破裂,髓核突出,从而压迫了腰椎内神经根、血管、脊髓或马尾神经所致的一系列临床症状,是骨伤科的常见病和多发病,其临床主要症状为腰、腿疼痛和一侧下肢放射痛及麻木。腰椎间盘突出症可发生在任何成年人,但多见于中老年人,男性多于女性。

  10. Comparative Analysis between Total Disc Replacement and Posterior Foraminotomy for Posterolateral Soft Disc Herniation with Unilateral Radiculopathy : Clinical and Biomechanical Results of a Minimum 5 Years Follow-up

    Science.gov (United States)

    Kim, Kyoung-Tae; Cho, Dae-Chul; Sung, Joo-Kyung; Kim, Young-Baeg; Kim, Du Hwan

    2017-01-01

    Objective To compare the clinical outcomes and biomechanical effects of total disc replacement (TDR) and posterior cervical foraminotomy (PCF) and to propose relative inclusion criteria. Methods Thirty-five patients who underwent surgery between 2006 and 2008 were included. All patients had single-level disease and only radiculopathy. The overall sagittal balance and angle and height of a functional segmental unit (FSU; upper and lower vertebral body of the operative lesion) were assessed by preoperative and follow-up radiographs. C2–7 range of motion (ROM), FSU, and the adjacent segment were also checked. Results The clinical outcome of TDR (group A) was tended to be superior to that of PCF (group B) without statistical significance. In the group A, preoperative and postoperative upper adjacent segment level motion values were 8.6±2.3 and 8.4±2.0, and lower level motion values were 8.4±2.2 and 8.3±1.9. Preoperative and postoperative FSU heights were 37.0±2.1 and 37.1±1.8. In the group B, upper level adjacent segment motion values were 8.1±2.6 and 8.2±2.8, and lower level motion values were 6.5±3.3 and 6.3±3.1. FSU heights were 37.1±2.0 and 36.2±1.8. The postoperative FSU motion and height changes were significant (p<0.05). The patient’s satisfaction rates for surgery were 88.2% in group A and 88.8% in group B. Conclusion TDR and PCF have favorable outcomes in patients with unilateral soft disc herniation. However, patients have different biomechanical backgrounds, so the patient’s biomechanical characteristics and economic status should be understood and treated using the optimal procedure. PMID:28061490

  11. 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

  12. 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。

  13. 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.

  14. Do design variations in the artificial disc influence cervical spine biomechanics? A finite element investigation

    OpenAIRE

    Faizan, Ahmad; Goel, Vijay K.; Garfin, Steven R.; Serhan, Hassan; Biyani, Ashok; Elgafy, Hossein; Krishna, Manoj; Friesem, Tai; Bono, Christopher M

    2009-01-01

    Various ball and socket-type designs of cervical artificial discs are in use or under investigation. Many artificial disc designs claim to restore the normal kinematics of the cervical spine. What differentiates one type of design from another design is currently not well understood. In this study, authors examined various clinically relevant parameters using a finite element model of C3–C7 cervical spine to study the effects of variations of ball and socket disc designs. Four variations of b...

  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. 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.

  18. Rehabilitation Nursing Experience of 105 Cases of Lumbar Disc Herniation%105例腰椎问盘突出症的康复护理体会

    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.

  19. Hybrid Surgery Versus Anterior Cervical Discectomy and Fusion in Multilevel Cervical Disc Diseases: A Meta-Analysis.

    Science.gov (United States)

    Zhang, Jianfeng; Meng, Fanxin; Ding, Yan; Li, Jie; Han, Jian; Zhang, Xintao; Dong, Wei

    2016-05-01

    To investigate the outcomes and reliability of hybrid surgery (HS) versus anterior cervical discectomy and fusion (ACDF) for the treatment of multilevel cervical spondylosis and disc diseases.Hybrid surgery, combining cervical disc arthroplasty (CDA) with fusion, is a novel treatment to multilevel cervical degenerated disc disease in recent years. However, the effect and reliability of HS are still unclear compared with ACDF.To investigate the studies of HS versus ACDF in patients with multilevel cervical disease, electronic databases (Medline, Embase, Pubmed, Cochrane library, and Cochrane Central Register of Controlled Trials) were searched. Studies were included when they compared HS with ACDF and reported at least one of the following outcomes: functionality, neck pain, arm pain, cervical range of motion (ROM), quality of life, and incidence of complications. No language restrictions were used. Two authors independently assessed the methodological quality of included studies and extracted the relevant data.Seven clinical controlled trials were included in this study. Two trials were prospective and the other 5 were retrospective. The results of the meta-analysis indicated that HS achieved better recovery of NDI score (P = 0.038) and similar recovery of VAS score (P = 0.058) compared with ACDF at 2 years follow-up. Moreover, the total cervical ROM (C2-C7) after HS was preserved significantly more than the cervical ROM after ACDF (P = 0.000) at 2 years follow-up. Notably, the compensatory increase of the ROM of superior and inferior adjacent segments was significant in ACDF groups at 2-year follow-up (P multilevel cervical spondylosis to preserve cervical ROM and reduce the risk of adjacent disc degeneration. Nonetheless, more well-designed studies with large groups of patients are required to provide further evidence for the benefit and reliability of HS for the treatment of cervical disk diseases.

  20. 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

  1. Computed tomography of the herniated lumbar disc: diagnostic difficulties and error

    Energy Technology Data Exchange (ETDEWEB)

    Weiss, T.; Treisch, J.; Claussen, C.; Banzer, D.

    1983-01-01

    In 310 computed axial tomograms of the lumbar spine which were studied retrospectively a number of pitfall situations were encountered. These in part were related to technical limitations, in part to degenerative joint disease and to postoperative hypertrophic scar formation. It became evident that the position of the disc within the intervertebral space may vary to a certain degree, a phenomenon not to be mistaken for disc protrusion.

  2. Motor control exercise for symptomatic lumbar disc herniation: protocol for a systematic review and meta-analysis

    Science.gov (United States)

    Pourahmadi, Mohammad Reza; Taghipour, Morteza; Ebrahimi Takamjani, Ismail; Sanjari, Mohammad Ali; Mohseni-Bandpei, Mohammad Ali; Keshtkar, Abbas Ali

    2016-01-01

    Introduction Lumbar disc herniation (LDH) is a common condition in adults and can impose a heavy burden on both the individual and society. It is defined as displacement of disc components beyond the intervertebral disc space. Various conservative treatments have been recommended for the treatment of LDH and physical therapy plays a major role in the management of patients. Therapeutic exercise is effective for relieving pain and improving function in individuals with symptomatic LDH. The aim of this systematic review is to evaluate the effectiveness of motor control exercise (MCE) for symptomatic LDH. Methods and analysis We will include all clinical trial studies with a concurrent control group which evaluated the effect of MCEs in patients with symptomatic LDH. We will search PubMed, SCOPUS, PEDro, SPORTDiscus, CINAHL, CENTRAL and EMBASE with no restriction of language. Primary outcomes of this systematic review are pain intensity and functional disability and secondary outcomes are functional tests, muscle thickness, quality of life, return to work, muscle endurance and adverse events. Study selection and data extraction will be performed by two independent reviewers. The assessment of risk of bias will be implemented using the PEDro scale. Publication bias will be assessed by funnel plots, Begg's and Egger's tests. Heterogeneity will be evaluated using the I2 statistic and the χ2 test. In addition, subgroup analyses will be conducted for population and the secondary outcomes. All meta-analyses will be performed using Stata V.12 software. Ethics and dissemination No ethical concerns are predicted. The systematic review findings will be published in a peer-reviewed journal and will also be presented at national/international academic and clinical conferences. Trial registration number CRD42016038166. PMID:27678542

  3. Correlation of 1.5 Tesla Magnetic Resonance Imaging with Clinical and Intraoperative Findings for Lumbar Disc Herniation

    Science.gov (United States)

    Bhave, Arvind; Patil, Sanjay

    2016-01-01

    Study Design A single-center prospective study. Purpose A magnetic resonance imaging (MRI) scan is undeniably the gold standard for the diagnosis of a lumbar disc prolapse. Unfortunately it shares a strong association with incidental findings. In this study, we aimed to determine the extent to which a 1.5 Tesla MRI correlates with the clinical features and intraoperative findings in cases of lumbar disc prolapse. Overview of Literature Few studies have correlated MRI with clinical findings, and none have extended this correlation to intraoperative findings. Methods Over a 2-year period, 50 consecutive patients with lumbar disc herniation requiring discectomy were studied. The MRI findings we observed consisted of the prolapse level, type, position, migration, high-intensity zones (HIZ), lateral recess, and foraminal stenosis. A logistic regression analysis was performed to determine the significance for the various MRI findings. Finally, the MRI observations were confirmed with intraoperative findings and inferences were drawn. Results MRI scan sensitivity and specificity for determining surgically significant levels was 100% and 94.94%, respectively. Straight leg raising test was positive in 74% of patients, with 85%, 43%, and 75% for paracentral, central, and foraminal levels, respectively. A foraminal compromise was the only MRI parameter to share a significant association with neurological deficits. Patients with a HIZ on the MRI had a significant increase in back pain and 63% exhibited identifiable annular tears intraoperatively. The intraoperative anatomical findings correlated extensively with the MRI findings. Conclusions MRI findings strongly correlate with intraoperative features and can serve as a useful tool when planning surgery due to the accurate depiction of the morphometric features. However, the decision for surgery should be made only when detailed clinical findings in conjunction with MRI findings allow for an accurate identification of the

  4. 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.

  5. Spinal sagittal imbalance in patients with lumbar disc herniation: its spinopelvic characteristics, strength changes of the spinal musculature and natural history after lumbar discectomy

    OpenAIRE

    Liang, Chen; Sun, Jianmin; Cui, Xingang; Jiang, Zhensong; Zhang, Wen; Li, Tao

    2016-01-01

    Background Spinal sagittal imbalance is a widely acknowledged problem, but there is insufficient knowledge regarding its occurrence. In some patients with lumbar disc herniation (LDH), their symptom is similar to spinal sagittal imbalance. The aim of this study is to illustrate the spinopelvic sagittal characteristics and identity the role of spinal musculature in the mechanism of sagittal imbalance in patients with LDH. Methods Twenty-five adults with spinal sagittal imbalance who initially ...

  6. 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.

  7. The Effects of Stretching with Lumbar Traction on VAS and Oswestry Scales of Patients with Lumbar 4–5 Herniated Intervertebral Disc

    OpenAIRE

    Yang, Hae-sun; Yoo, Won-gyu

    2014-01-01

    [Purpose] This study investigated the effect of stretching with lumbar traction on VAS and Oswestry scale scores of lumbar 4–5 herniated intervertebral disc (HIVD) patients. [Subjects] We recruited 20 lumbar 4–5 HIVD patients. [Methods] We performed stretching with lumbar traction for lumbar 4–5 HIVD patients during 4 weeks. The VAS and Oswestry scales were measured before and 4 weeks after the intervention. [Results] The results showed a significant decrease in VAS scale scores for stretchin...

  8. Influences of spinal decompression therapy and general traction therapy on the pain, disability, and straight leg raising of patients with intervertebral disc herniation

    OpenAIRE

    Choi, Jioun; Lee, Sangyong; Hwangbo, Gak

    2015-01-01

    [Purpose] The purpose of this study was to identify how spinal decompression therapy and general traction therapy influence the pain, disability, and straight leg raise (SLR) ability of patients with intervertebral disc herniation. [Subjects] The subjects were 30 patients with chronic lumbar pain who were divided into a spinal decompression therapy group (SDTG, n=15), and a general traction therapy group (GTTG, n=15). [Methods] The SDTG used a spinal decompression device, and the GTTG used a ...

  9. Long term preservation of motion with artificial cervical disc implants: A comparison between cervical disc replacement and rigid fusion with cage

    Science.gov (United States)

    Cincu, Rafael; Lorente, Francisco de Asis; Gomez, Joaquin; Eiras, Jose; Agrawal, Amit

    2014-01-01

    Background: With the advancement of technologies there is more interest in the maintenance of the spine's biomechanical properties focusing on the preservation of the functional motion segment. In present article we describe our experience with 25 cases managed with artificial cervical discs with 28 Solis cage following cervical discectomy with a mean follow-up period of 7.5 year. Materials and Methods: All surgeries were performed by single surgeon from March 2004 to June 2005 with a follow-up till date. Patients with symptomatic single or multiple level diseases that had no prior cervical surgery were candidates for the study. Cohort demographics were comparable. Standardized clinical outcome measures and radiographic examinations were used at prescribed post-operative intervals to compare the treatment groups. Relief in radicular pain, cervical spine motion, and degenerative changes at follow-up were noted. Results: In a total 53 cases, the mean age in prosthesis group was 47 years (age range: 30-63 years) and mean age in cage group was 44 years (32-62 years). Mean hospital stay was 2.7 days in both the groups. At 4 weeks complete cervical movements could be achieved in 19 cases in artificial disc group. Maintenance of movement after 7.5 years was in 76% of these patients. Lordosis was maintained in all cases till date. There was no mortality or wound infection in our series. Conclusions: We conclude that artificial cervical disc could be an alternative to fixed spinal fusion as it represents the most physiological substitute of disc. However, there is need for further studies to support the use of artificial cervical disc prosthesis. PMID:25685218

  10. Upper thoracic-spine disc degeneration in patients with cervical pain

    Energy Technology Data Exchange (ETDEWEB)

    Arana, Estanislao; Marti-Bonmati, Luis; Costa, Salvador [Department of Radiology, Clinica Quiron, Avda Blasco Ibanez 14, 46010, Valencia (Spain); Molla, Enrique [Department of Radiology, Clinica Quiron, Avda Blasco Ibanez 14, 46010, Valencia (Spain); Department of Morphological Sciences, University of Valencia, Valencia (Spain)

    2004-01-01

    To study the relationship of upper thoracic spine degenerative disc contour changes on MR imaging in patients with neck pain. The relation between upper thoracic and cervical spine degenerative disc disease is not well established. One hundred and fifty-six patients referred with cervical pain were studied. There were 73 women and 77 men with a mean age of 48.6{+-}14.6 years (range, 19 to 83 years). All MR studies were performed with a large 23-cm FOV covering at least from the body of T4 to the clivus. Discs were coded as normal, protrusion/bulge or extrusion. Degenerative thoracic disc contour changes were observed in 13.4% of patients with cervical pain. T2-3 was the most commonly affected level of the upper thoracic spine, with 15 bulge/protrusions and one extrusion. Upper degenerative thoracic disc contour changes presented in older patients than the cervical levels (Student-Newman-Keuls test, P<0.001). Degenerative disc contour changes at the C7-T1, T1-2, T2-3 and T3-4 levels were significantly correlated (P=0.001), but unrelated to any other disc disease, patient's gender or age. Degenerative cervical disc disease was closely related together (P<0.001), but not with any thoracic disc. A statistically significant relation was found within the upper thoracic discs, reflecting common pathoanatomical changes. The absence of relation to cervical segments is probably due to differences in their pathomechanisms. (orig.)

  11. 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.

  12. 推拿治疗腰椎间盘突出症150 例%Tuina Treatment of 150 Cases with Lumbar Intervertebral Disc Herniation

    Institute of Scientific and Technical Information of China (English)

    雷龙鸣; 黄锦军; 何育风; 段文魁; 唐宏亮; 甘炜; 韩丑萍

    2011-01-01

    Objective: To observe the clinical efficacy of tuina treatment for lumbar intervertebral disc herniation. Methods: 150 cases with lumbar intervertebral disc herniation were treated with tuina, followed by a retrospective analysis and summarization on the clinical efficacy. Results: 43 cases obtained clinical recovery, 67 cases had a marked effect, 34 cases had improvement and 6 cases failed. The total effective rate was 96.0%. Conclusion: Tuina is effective for lumbar intervertebral disc herniation.%目的:观察推拿治疗腰椎间盘突出症的临床疗效.方法:对150 例腰椎间盘突出症门诊患者采用推拿治疗,并对其临床疗效进行回顾性的分析和总结.结果:临床痊愈43 例,显效67 例,有效34 例,无效6 例,总有效率为96.0% .结论:推拿对腰椎间盘突出症具有较好的疗效.

  13. 腰椎间盘突出症的非手术治疗%Non-surgical Treatment of Lumbar Disc Herniation

    Institute of Scientific and Technical Information of China (English)

    倪家骧

    2012-01-01

    腰椎间盘突出症是一种部分自限性疾病,随着放射介入技术的推广,微创介入治疗技术近年来得到广泛应用,显著降低了腰椎间盘突出症的手术治疗率,非手术治疗成为本病的基本治疗方法.本文主要论述腰椎间盘突出症的非手术治疗方法,为临床提供参考.%Lumbar disc herniation is a partly self - limited disease, and with the development of radiology intervention-al techniques, minimally invasive treatment techniques have been widely applied in recent years, which significantly reduced the rate of surgical treatment for lumbar disc herniation, turning non - surgical treatment into a basic therapy for the disease. This paper mainly reviewed non - surgical therapies of lumbar disc herniation in order to provide references for clinic.

  14. 短波电局泥治疗腰椎间盘突出症疗效观察%Efficacy of lumbar disc herniation shortwave Bureau mud treatment

    Institute of Scientific and Technical Information of China (English)

    李艳

    2014-01-01

    目的:观察短波电局泥疗法对腰椎间盘突出症的疗效。方法40例腰椎间盘突出症患者随机分为两组,均采用按摩疗法,研究组加用短波电局泥疗法。结果治疗24天后,两组患者症状明显改善,研究组效果明显优于对照组(P<0.05)。结论短波电局泥疗法治疗腰椎间盘突出症效果好。%Objective To observe the effect of short-wave electrical bureau mud therapy for lumbar disc herniation. Methods 40 patients with lumbar disc herniation were randomly divided into two groups, are using massage therapy, research group with shortwave Bureau mud therapy. The results for 24 days, both groups significantly improved symptoms, the study group was better than in the control group (P <0.05). Conclusion Bureau mud therapy shortwave electric lumbar disc herniation good effect.

  15. 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

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    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.

  16. Effect Observation of Massage in Treatment of Lumbar Disc Herniation%按摩治疗腰椎间盘突出症的疗效观察

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    程利群

    2013-01-01

    Objective: To observe the efficacy of massage in treatment of lumbar disc hernia-tion. Methods: 122 patients with lumbar disc herniation were treated by massage according to the type of disease. Results:28 cases were cured, 37 cases had marked effect, 53 cases were improved, and 4 cases were invalid. The total effective rate was 96.72%. Conclusion:The effect of massage in treatment of lumbar disc herniation is good.%  目的:观察按摩治疗腰椎间盘突出症的疗效.方法:根据分型施以相应的按摩手法治疗122例腰椎间盘突出症患者.结果:痊愈28例,显效37例,好转53例,无效4例,总有效率96.72%.结论:按摩治疗腰椎间盘突出症效果较好.

  17. Effect of Electro-acupuncture on Matrix Metalloproteinase in Degenerated Cervical Intervertebral Disc of Rats

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    SHI Zheng; HUANG Qiang; MA Xiao-peng; LIU Shi-min; LIU Hui-rong; ZHU Zhong-chun

    2007-01-01

    To observe the effect of electro-acupuncture on matrix metalloproteinase in degenerated cervical intervertebral disc rats.Methods:The rat model of cervical intervertebral disc degeneration was induced by unbalanced dynamic and static forces,then the rats were randomly allocated to model group,electro-acupuncture groupⅠ(acupoints Dazhu(BL 11) and Tianzhu(BL 10) were electro-acupunctured),and electro-acupuncture group Ⅱ(acupoints Dazhu (BL 11),Tianzhu(BL 10)and Shenshu(BL 23) were electro-acupunctured),with the normal rats as control.then the HE staining method was adopted to observe the morphological change of cervical intervertebral disc and the immunohistochemical staining method was used to detect the marx metalloproteinases-1(MMP-1) and matrix metalloproteinases-3(MMP-3) in cervical intervertebral disc.Results:The morphological observation showed that after electro-acupuncture treatment,the degrees of cervical intervertebral disc degeneration in electro-acupuncture groupⅠand electro-acupuncture group Ⅱ were alleviated,and the electro-acupuncture group Ⅱ was superior to electro-acupuncture group Ⅰ.The expressions of MMP-1 and MMP-3 in degenerated cervical intervertebral disc were increased(P<0.01),and after electro-acupuncture treatment,the expressions of MMP-1 and MMP-3 in degenerated cervical intervertebral disc were decreased,especially the electro-acupuncture group Ⅱpresented the better effect as compared with electro-acupuncture group Ⅰ(P<0.05).Conclusions:Electro-acupuncture at acupoints Dazhu (BL 11) and Tianzhu (BL 10) had a certain therapeutic effect on cervical intervertebral disc degeneration,and in combination with acupoint Shenshu(BL 23),this therapeutic effect could be enhanced,its action mechanism might be that electro-acupuncture can reduce the expressions of MMP-l and MMP-3 in degenerated cervical intervertebral disc,inhibit the degradation of matrix in intervertebral disc.so as to relieve cervical intervertebral disc

  18. 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.

  19. 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.

  20. Scoliotic posture as the initial symptom in adolescents with lumbar disc herniation: its curve pattern and natural history after lumbar discectomy

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    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

  1. Integrative TCM Conservative Therapy for Low Back Pain due to Lumbar Disc Herniation: A Randomized Controlled Clinical Trial

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    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.

  2. Comparative analysis of the influence of Fructus Ligustri Lucidi on a rat lumbar disc herniation model.

    Science.gov (United States)

    Han, Ya-Xin; Liang, Dong; Han, Xiao-Rui; Liang, De-Yong

    2015-07-01

    Lumbar disc herniation (LDH) is a term used for a group of conditions, including back pain, femoral nerve pain and sciatica. Currently available treatments and surgical options are insufficient for patients with LDH. Fructus Ligustri Lucidi (FLL) is a herb that is used for treating age-associated diseases. The results of the present study suggested that FLL may be used for treatment of patients with LDH. In the present study, matrix metalloproteinase-1, -3, -8 and -9 (MMP-1, -3, -8 and -9) protein and mRNA expression downregulation was observed in patients with LDH according to western blotting and reverse transcription-quantitative polymerase chain reaction. By contrast, upregulation of interleukin-2 (IL-2), IL-6, IL-8 and tumor necrosis factor-α (TNF-α) expression was observed in patients with LDH, according to an enzyme-linked immunosorbent assay. Mechanical allodynia was observed in rats with LDH not treated with FLL; however, not in FLL‑treated rats. IL-2, IL-6, IL-8 and TNF-α expression levels in the serum from untreated rats were significantly higher than that of the FLL‑treated rat models. Protein expression levels of MMPs in FLL-treated rats were lower than those in untreated rats. However, the mechanisms underlying the association between FLL and protein expression levels require further investigation.

  3. In-vivo T2-relaxation times of asymptomatic cervical intervertebral discs

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    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.)

  4. Effects of acupuncture, core-stability exercises, and treadmill walking exercises in treating a patient with postsurgical lumbar disc herniation: a clinical case report.

    Science.gov (United States)

    Ganiyu, Sokunbi Oluwaleke; Gujba, Kachalla Fatimah

    2015-02-01

    The objective of this study is to investigate the effects of acupuncture, core-stability exercises, and treadmill 12-minute walking exercises in treating patients with postsurgical lumbar disc herniation. A 34-year-old woman with a history lumbar disc prolapse who had undergone lumbar disc surgery on two different occasions was treated using acupuncture, core-stability exercises, and treadmill walking exercises three times per week for 12 weeks. The outcome measures used in this study were pain intensity, spinal range of movement, and general health. After 12 weeks of treatment, the patient had made improvement in terms of pain, which was reduced from 9/10 to 1/10. In a similar vein, the patient's general health showed improvement of >100% after 12 weeks of treatment. Pre-treatment scores of spinal flexion and left-side flexion, which measured 20 cm and 12 cm, respectively, increased to 25 cm and 16 cm after 12 weeks of treatment. This study showed that acupuncture, core-stability exercises, and treadmill walking exercises were useful in relieving pain, increasing spinal range of movement, and improving the health of a patient with postsurgical lumbar disc herniation.

  5. An Outcome Study of Anterior Cervical Discectomy and Fusion among Iranian Population.

    Science.gov (United States)

    Haghnegahdar, Ali; Sedighi, Mahsa

    2016-01-01

    Background and Aim. First-line treatment strategy for managing cervical disc herniation is conservative measures. In some cases, surgery is indicated either due to signs/symptoms of severe/progressive neurological deficits, or because of persistence of radicular pain despite 12 weeks of conservative treatment. Success for treatment of cervical disc herniation using ACDF has been successfully reported in the literature. We aim to determine the outcome of ACDF in treatment of cervical disc herniation among Iranians. Methods and Materials/Patients. In a retrospective cohort study, we evaluated 68 patients who had undergone ACDF for cervical disc herniation from March 2006 to March 2011. Outcome tools were as follows: (1) study-designed questionnaire that addressed residual and/or new complaints and subjective satisfaction with the operation; (2) recent (one week prior to the interview) postoperative VAS for neck and upper extremity radicular pain; (3) Japanese Orthopaedic Association Myelopathy Evaluation Questionnaire (JOACMEQ) (standard Persian version); and (4) follow-up cervical Magnetic Resonance Imaging (MRI) and lateral X-ray. Results. With mean follow-up time of 52.93 (months) ± 31.89 SD (range: 13-131 months), we had success rates with regard to ΔVAS for neck and radicular pain of 88.2% and 89.7%, respectively. Except QOL functional score of JOAMEQ, 100% success rate for the other 4 functional scores of JOAMEQ was achieved. Conclusion. ACDF is a successful surgical technique for the management of cervical disc herniation among Iranian population.

  6. 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.

  7. Preoperative motor deficit in lumbar disc herniation and its influence on quality of life

    Directory of Open Access Journals (Sweden)

    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.

  8. 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

  9. Do design variations in the artificial disc influence cervical spine biomechanics? A finite element investigation.

    Science.gov (United States)

    Faizan, Ahmad; Goel, Vijay K; Garfin, Steven R; Bono, Christopher M; Serhan, Hassan; Biyani, Ashok; Elgafy, Hossein; Krishna, Manoj; Friesem, Tai

    2012-06-01

    Various ball and socket-type designs of cervical artificial discs are in use or under investigation. Many artificial disc designs claim to restore the normal kinematics of the cervical spine. What differentiates one type of design from another design is currently not well understood. In this study, authors examined various clinically relevant parameters using a finite element model of C3-C7 cervical spine to study the effects of variations of ball and socket disc designs. Four variations of ball and socket-type artificial disc were placed at the C5-C6 level in an experimentally validated finite element model. Biomechanical effects of the shape (oval vs. spherical ball) and location (inferior vs. superior ball) were studied in detail. Range of motion, facet loading, implant stresses and capsule ligament strains were computed to investigate the influence of disc designs on resulting biomechanics. Motions at the implant level tended to increase following disc replacement. No major kinematic differences were observed among the disc designs tested. However, implant stresses were substantially higher in the spherical designs when compared to the oval designs. For both spherical and oval designs, the facet loads were lower for the designs with an inferior ball component. The capsule ligament strains were lower for the oval design with an inferior ball component. Overall, the oval design with an inferior ball component, produced motion, facet loads, implant stresses and capsule ligament strains closest to the intact spine, which may be key to long-term implant survival.

  10. 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.

  11. Comparing clinical outcomes of repeat discectomy versus fusion for recurrent disc herniation utilizing the N(2)QOD.

    Science.gov (United States)

    Guan, Jian; Ravindra, Vijay M; Schmidt, Meic H; Dailey, Andrew T; Hood, Robert S; Bisson, Erica F

    2017-01-01

    OBJECTIVE Recurrent lumbar disc herniation (RLDH) is a significant cause of morbidity in patients undergoing lumbar discectomy and has been reported to occur in up to 18% of cases. While repeat discectomy is often successful in treating these patients, concern over repeat RLDH may lead surgeons to advocate instrumented fusion even in the absence of instability. The authors' goal was to compare clinical outcomes for patients undergoing repeat discectomy versus instrumented fusion for RLDH. METHODS The authors used the National Neurosurgery Quality and Outcomes Database (N(2)QOD) to assess outcomes of patients who underwent repeat discectomy versus instrumented fusion at a single institution from 2012 to 2015. Primary outcomes included Oswestry Disability Index (ODI) score, visual analog scale (VAS) score, and quality-adjusted life year (QALY) measures. Secondary outcomes included hospital length of stay, discharge status, and hospital charges. RESULTS The authors identified 25 repeat discectomy and 12 instrumented fusion patients with 3- and 12-month follow-up records. The groups had similar ODI and VAS scores and QALY measurements at 3 and 12 months. Patients in the instrumented fusion group had significantly longer hospitalizations (3.7 days vs 1.0 days, p fusion group were also significantly higher ($54,458.29 vs $11,567.05, p fusion result in similar clinical outcomes at short-term follow-up. Patients undergoing repeat discectomy had significantly shorter operative times and length of stay, and they incurred dramatically lower hospital charges. They were also less likely to require acute rehabilitation postoperatively. Further research is needed to compare these two management strategies.

  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. Changes in the Expressions of Iba1 and Calcitonin Gene-Related Peptide in Adjacent Lumbar Spinal Segments after Lumbar Disc Herniation in a Rat Model.

    Science.gov (United States)

    Cho, Hee Kyung; Ahn, Sang Ho; Kim, So-Yeon; Choi, Mi-Jung; Hwang, Se Jin; Cho, Yun Woo

    2015-12-01

    Lumbar disc herniation is commonly encountered in clinical practice and can induce sciatica due to mechanical and/or chemical irritation and the release of proinflammatory cytokines. However, symptoms are not confined to the affected spinal cord segment. The purpose of this study was to determine whether multisegmental molecular changes exist between adjacent lumbar spinal segments using a rat model of lumbar disc herniation. Twenty-nine male Sprague-Dawley rats were randomly assigned to either a sham-operated group (n=10) or a nucleus pulposus (NP)-exposed group (n=19). Rats in the NP-exposed group were further subdivided into a significant pain subgroup (n=12) and a no significant pain subgroup (n=7) using mechanical pain thresholds determined von Frey filaments. Immunohistochemical stainings of microglia (ionized calcium-binding adapter molecule 1; Iba1), astrocytes (glial fibrillary acidic protein; GFAP), calcitonin gene-related peptide (CGRP), and transient receptor potential vanilloid 1 (TRPV1) was performed in spinal dorsal horns and dorsal root ganglions (DRGs) at 10 days after surgery. It was found immunoreactivity for Iba1-positive microglia was higher in the L5 (P=0.004) dorsal horn and in the ipsilateral L4 (P=0.009), L6 (P=0.002), and S1 (P=0.002) dorsal horns in the NP-exposed group than in the sham-operated group. The expression of CGRP was also significantly higher in ipsilateral L3, L4, L6, and S1 segments and in L5 DRGs at 10 days after surgery in the NP-exposed group than in the sham-operated group (Plumbar disc herniation upregulates microglial activity and CGRP expression in many adjacent and ipsilateral lumbar spinal segments.

  14. Clinical Analysis of Rehabilitation Massage Therapy for Lumbar Disc Herniation%康复推拿治疗腰椎间盘突出症临床分析

    Institute of Scientific and Technical Information of China (English)

    李青松

    2015-01-01

    目的 探究分析临床应用康复推拿治疗腰椎间盘突出症的疗效.方法 将我院收治的60例腰椎间盘突出症患者随机分为观察组及对照组.观察组行康复推拿治疗,对照组行一般推拿治疗,比较两组患治疗3周后的康复状况.结果 治疗3周后观察组患者的疼痛评分、JOA下腰痛评分等均优于对照组,观察组患者的临床疗效优于对照组.结论 对于腰椎间盘突出症(LDH)患者,临床采用康复推拿治疗后患者的疼痛改善情况、活动等效果均优于单纯的推拿治疗,临床康复效果较理想.%Objective To explore the efficacy of clinical application of rehabilitation massage treatment for lumbar disc herniation.Methods Selected 60 cases of patients with lumbar disc herniation in our hospital, randomly divided into observation group and control group, patients in observation group with rehabilitative massage therapy, the others in control group by general massage therapy, then compared two rehabilitation status of two groups after treated 3 weeks.Results The clinical curative effect in observation group was better than it in control group, in terms of pain score and JOA score after treated 3 weeks.Conclusion Rehabilitation massage treatment for lumbar disc herniation has better effect than the pure massage therapy, in terms of improvement pain and activity, so it has ideal rehabilitation effect in clinic.

  15. Treatment of Lumbar Intervertebral disc Herniation with Electroacupuncture on Jiaji Points (Ex-B 2) plus TDP: A Report of 68 Cases

    Institute of Scientific and Technical Information of China (English)

    FAN Chun-jiang; HAN Chou-ping

    2004-01-01

    取病变部位夹脊穴,进行电针,治疗68例腰椎间盘突出症患者,治疗3个疗程后痊愈35例,好转28例,无效5例,总有效率92.6%.%Sixty-eight lumbar intervertebral disc herniation (LDH) cases were treated with electroacupuncture on Jiaji points of the affected area with the following result after three courses of treatment: and 35 cases got recovery, 28 cases got better result, 5 cases had no effect, and the total effective rate was 92.6%.

  16. 中医治疗腰椎间盘突出症临床研究概述%Traditional Chinese medicine for the treatment of lumbar disc herniation clinical research overview

    Institute of Scientific and Technical Information of China (English)

    罗奇; 唐晓菊; 唐正中

    2014-01-01

    腰椎间盘突出症为骨科常见病,非手术治疗方法很多,治疗效果各异。文章综述了对各种针对腰椎间盘突出症的中医传统治疗方法及疗效。%Lumbar disc herniation is a common disease in Department of orthopedics, many non operation treatment method, and treatment effect of different. This paper reviews on various according to the curative effect of Chinese traditional treatment method of lumbar disc herniation.

  17. 蜈蚣细辛汤配温针治疗腰椎间盘突出症30例临床观察%Clinical observation on treating lumbar disc herniation with the Wugong Xixin decoction plus warm acupuncture

    Institute of Scientific and Technical Information of China (English)

    孔荣

    2013-01-01

      腰间盘突出症是临床常见疾病,可表现为腰痛合并下肢痛,通过对30例患者临床治疗的观察,证实了蜈蚣细辛汤配温针治疗腰椎间盘突出症疗效显著。%Lumbar disc herniation is a common clinical disease, it can be expressed as lumbago combined with leg pain. Through the clinical treatment observation of 30 patients, confirmed that Wugong Xixin decoction plus warm acupuncture was significantly effective in treating lumbar disc herniation.

  18. Cervical total disc replacement is superior to anterior cervical decompression and fusion: a meta-analysis of prospective randomized controlled trials.

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    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.

  19. 浅谈对腰椎间盘突出症诊疗的认识%On the Primary Understanding of Diagnosis and Treatments of Lumbar Disc Herniation

    Institute of Scientific and Technical Information of China (English)

    张文柳; 罗凛

    2013-01-01

    The prolapse of lumbar intervertebral disc is common clinical disease, and its therapies are various. This paper summariz-es the treatments of lumbar disc herniation respectively from western medicine and Chinese medicine, and puts forward some per-sonal opinions for clinical reference.%  腰椎间盘突出症是临床常见病,其治疗方法多样。现分别从西医及中医两方面对腰椎间盘突出症的治疗作一综述,并提出个人的一些见解,以供临床参考。

  20. 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.

  1. Ranges of Cervical Intervertebral Disc Deformation during an In-Vivo Dynamic Flexion-Extension of the Neck.

    Science.gov (United States)

    Yu, Yan; Mao, Haiqing; Li, Jing-Sheng; Tsai, Tsung-Yuan; Cheng, Liming; Wood, Kirkham B; Li, Guoan; Cha, Thomas D

    2017-03-23

    While abnormal loading is widely believed to cause cervical spine disc diseases, in-vivo cervical disc deformation during dynamic neck motion has not been well delineated. This study investigated the range of cervical disc deformation during an in-vivo functional flexion-extension of the neck. Ten asymptomatic human subjects were tested using a combined dual fluoroscopic imaging system and MRI based 3D modeling technique. Overall disc deformation was determined using the changes of the space geometry between upper and lower endplates of each intervertebral segment (C3/4, C4/5, C5/6 and C6/7). Five points (anterior, center, posterior, left and right) of each disc were analyzed to examine the disc deformation distributions. The data indicated that between the functional maximum flexion and extension of the neck, the anterior points of the discs experienced large changes of distraction/compression deformation and shear deformation. The higher level discs experienced higher ranges of disc deformation. No significant difference was found in deformation ranges at posterior points of all discs. The data indicated that the range of disc deformation is disc level dependent and the anterior region experienced larger changes of deformation than the center and posterior regions, except for the C6/7 disc. The data obtained from this study could serve as baseline knowledge for the understanding of the cervical spine disc biomechanics and for investigation of the biomechanical etiology of disc diseases. These data could also provide insights for development of motion preservation surgeries for cervical spine.

  2. Hyperexcitability in Spinal WDR Neurons following Experimental Disc Herniation Is Associated with Upregulation of Fractalkine and Its Receptor in Nucleus Pulposus and the Dorsal Root Ganglion

    Science.gov (United States)

    Moen, Aurora; Haugen, Fred; Gjerstad, Johannes

    2016-01-01

    Introduction. Lumbar radicular pain following intervertebral disc herniation may be associated with a local inflammatory response induced by nucleus pulposus (NP) cells. Methods. In anaesthetized Lewis rats, extracellular single unit recordings of wide dynamic range (WDR) neurons in the dorsal horn and qPCR were used to explore the effect of NP application onto the dorsal nerve roots (L3–L5). Results. A clear increase in C-fiber response was observed following NP conditioning. In the NP tissue, the expression of interleukin-1β (IL-1β), colony stimulating factor 1 (Csf1), fractalkine (CX3CL1), and the fractalkine receptor CX3CR1 was increased. Minocycline, an inhibitor of microglial activation, inhibited the increase in neuronal activity and attenuated the increase in IL-1β, Csf1, CX3L1, and CX3CR1 expression in NP tissue. In addition, the results demonstrated an increase in the expression of TNF, CX3CL1, and CX3CR1 in the dorsal root ganglions (DRGs). Conclusion. Hyperexcitability in the pain pathways and the local inflammation after disc herniation may involve upregulation of CX3CL1 signaling in both the NP and the DRG. PMID:28116212

  3. The significance of Gd-DTPA enhanced MRI for lumbar disc herniation; The relationship between nerve root enhancement and clinical manifestations

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    Taneichi, Hiroshi; Abumi, Kuniyoshi; Hirachi, Kazuhiko; Kaneda, Kiyoshi (Hokkaido Univ., Sapporo (Japan). School of Medicine)

    1993-04-01

    The purpose of this study was twofold: to determine the ability of Gd-DTPA enhanced MRI to enhance the nerve root and to determine its clinical value in lumbar disc herniation. One hundred and fifteen patients underwent enhanced MRI before and after surgery. Disturbed nerve root was demonstrated on enhanced MRI before surgery in 39.1% (45/115). Nerve root enhancement was occasionally associated with severe leg pain, but not associated with the degree of paralysis. Nerve root enhancement early after surgery was positive in 27 of 46 patients (58.7%), revealing no clinical usefulness of enhanced MRI. Non-damaged nerve root was enhanced in 7 patients (5.9%). This may reflect enhancement of root vein. Nerve root enhancement has the potential for visualizing endoneurial edema resulting from compression and inflammation of the nerve root. Enhanced MRI demonstrated lesions within the nerve root, allowing identification of damaged nerve root and diagnosis of lumbar disc herniation. (N.K.).

  4. Hyperexcitability in Spinal WDR Neurons following Experimental Disc Herniation Is Associated with Upregulation of Fractalkine and Its Receptor in Nucleus Pulposus and the Dorsal Root Ganglion

    Directory of Open Access Journals (Sweden)

    Daniel Pitz Jacobsen

    2016-01-01

    Full Text Available Introduction. Lumbar radicular pain following intervertebral disc herniation may be associated with a local inflammatory response induced by nucleus pulposus (NP cells. Methods. In anaesthetized Lewis rats, extracellular single unit recordings of wide dynamic range (WDR neurons in the dorsal horn and qPCR were used to explore the effect of NP application onto the dorsal nerve roots (L3–L5. Results. A clear increase in C-fiber response was observed following NP conditioning. In the NP tissue, the expression of interleukin-1β (IL-1β, colony stimulating factor 1 (Csf1, fractalkine (CX3CL1, and the fractalkine receptor CX3CR1 was increased. Minocycline, an inhibitor of microglial activation, inhibited the increase in neuronal activity and attenuated the increase in IL-1β, Csf1, CX3L1, and CX3CR1 expression in NP tissue. In addition, the results demonstrated an increase in the expression of TNF, CX3CL1, and CX3CR1 in the dorsal root ganglions (DRGs. Conclusion. Hyperexcitability in the pain pathways and the local inflammation after disc herniation may involve upregulation of CX3CL1 signaling in both the NP and the DRG.

  5. Influences of spinal decompression therapy and general traction therapy on the pain, disability, and straight leg raising of patients with intervertebral disc herniation.

    Science.gov (United States)

    Choi, Jioun; Lee, Sangyong; Hwangbo, Gak

    2015-02-01

    [Purpose] The purpose of this study was to identify how spinal decompression therapy and general traction therapy influence the pain, disability, and straight leg raise (SLR) ability of patients with intervertebral disc herniation. [Subjects] The subjects were 30 patients with chronic lumbar pain who were divided into a spinal decompression therapy group (SDTG, n=15), and a general traction therapy group (GTTG, n=15). [Methods] The SDTG used a spinal decompression device, and the GTTG used a lumbar traction device. Both groups received conservative physical therapy three times a week for four weeks. A visual analog scale (VAS) was used to measure the degree of pain the patients with chronic lumbar pain. The Oswestry Disability Index (ODI) was used to measure the degree of functional disability. A goniometer was used to measure the patients' SLR ability. [Results] Both SDTG and GTTG showed statistically significant decreases in VAS and ODI scores and a statistically significant increase in SLR angle. A comparison of the two groups found no statistically significant differences. [Conclusion] Spinal decompression therapy and general traction therapy are effective at improving the pain, disability, and SLR of patients with intervertebral disc herniation. Thus, selective treatment may be required.

  6. The effect of age on result of straight leg raising test in patients suffering lumbar disc herniation and sciatica

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    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. MULTIMODAL PHYSIOTHERAPEUTIC APPROACH IN TREATING A PATIENT WITH ACUTE CERVICAL DISC PROLAPSE: A CASE REPORT

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    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.

  8. 微创治疗腰椎间盘突出的研究%Study on Minimally Invasive Treatment for Lumbar Disc Herniation

    Institute of Scientific and Technical Information of China (English)

    韩田浦

    2015-01-01

    目的:通过对腰椎间盘突出相关疗法进行回顾,了解当前微创疗法进展,针对我院腰椎间盘突出症患者,对其进行微创手术治疗后效果进行分析。方法选取我院腰椎间盘突出症患者100例,随机均分为观察组和对照组,观察组采用微创疗法,对照组采取保守的非手术疗法。结果统计数据分析得出两组患者的疗效存在较大差异(<0.05)。结论微创治疗有效增进了最终疗效,加快腰椎间盘突出症患者身体的康复进程,并且患者在完成手术后没有严重并发症。%Objective Tto through the review of the lumbar disc herniation related therapy, know the progress of the cur ent minimal y invasive therapy, for the patient of lumbar protrusion of the intervertebral disc, the were minimal y invasive surgical treatment ef ect analysis. Methods 100 patients with lumbar disc herniation in our hospital were randomly divided into observation group and control group. The observation group were treated with minimal y invasive therapy, and the control group were treated with conservative non operative treatment.Results There were significant dif erences in the ef icacy of the two groups ( < 0.05). Conclusion Minimal y invasive treatment can ef ectively improve the final ef ect, and accelerate the rehabilitation progress of patients with lumbar disc herniation, and there are no serious complications after the operation.

  9. Bryan人工颈椎间盘置换术治疗颈椎病的中期疗效观察%Midterm results of cervical disc replacement with the Bryan cervical disc prosthesis for cervical disc disorders

    Institute of Scientific and Technical Information of China (English)

    姜宇; 田野; 王以朋; 邱贵兴; 翁习生; 冯宾

    2011-01-01

    目的 观察Bryan人工颈椎间盘置换术治疗颈椎病的中期疗效.方法 2005年11月至2010年5月对16例颈椎病患者行Bryan人工颈椎间盘置换术.统计并分析患者术前、术后及末次随访时的JOA评分、置换节段活动度,观察术后及末次随访时假体松动、移位、异位骨化等并发症.结果 16例患者均获得随访,随访时间为12~53个月,平均24.1个月,JOA评分由术前平均(10.4±1.9)分增至术后平均(14.4±1.9)分以及末次随访平均(16.1±0.7)分,术前与术后(t=-12.215,P=0.000)、术后与末次随访(t=-4.273,P=0.001)均有显著性差异.12例患者随访时行颈椎屈伸位X线片检查,随访时间13~53月,平均24.2月,测量屈伸位X线片计算置换节段颈椎屈伸活动度(range of motion,ROM),术前平均7.1°±2.6°、术后平均6.9°±1.9°、末次随访平均6.5°±1.8°,术前与术后(t=0.700,P=0.395)、术后与末次随访(t=2.132,P=0.054)均无统计学差异.无一例发生异位骨化;1例随访时出现假体周围骨吸收.结论 Bryan人工颈椎间盘置换术治疗颈椎病的中期疗效满意,但仍需长时间随访以评估其远期疗效.%Objective To investigate the midterm outcomes of cervical disc replacement with Bryan cervical disc prosthesis for cervical disc disorders. Methods Sixteen patients with cervical disc disorders were performed cervical disc replacement with 16 Bryan discs from November 2005 to May 2010. The JOA score and range of motion ( ROM) of the implanted disc level were measured pre-operatively, post-operatively and at final follow-up. Complications of prosthesis dislodgement, heterotopic ossification and so on were also analyzed. Results All cases obtained the follow-up with an average of 24. 1 months (ranged 12 to 53 months). The average JOA score was 10.4 ± 1.9 pre-operatively, 14.4 ± 1. 9 post-operatively and 16. 1 ± 0.7 at final follow-up. There were significantly statistical difference between per-operativelyand post

  10. Herniación discal intravertebral cervical (Nódulo de Schmorl en un perro Cervical intravertebral disk herniation (Schmorl's node in a dog

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    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

  11. 推拿手法治疗腰椎间盘突出症的机制%A study on mechanism of manipulation used in lumbar disc herniation

    Institute of Scientific and Technical Information of China (English)

    毕胜; 李义凯; 赵卫东; 张勇; 侯京山; 王福根

    2001-01-01

    Objective: To study the mechanism of manipulation in treating for lumbar disc herniation by means of biomechanics. Method: 5 cadaver lumbar spines were loaded on a Material Test System, computerzed quantitative control to simulate different manipulations,and an extensometer were used to measure the range of displacement between nerve roots and discs. Result: The range of displacement three kinds of manipulations were respectively 1.283± 0.758mm, 1.411±0.769mm and 1.348 ±0.774mm. Conclusion:The mechanism of manipulation for lumbar disc herniation might be that the pressure and stimulation of the disc protrusion on the nerve root was reduced by relative displacement of the nerve roots,and loosened the adhesion between the disc protrusion and the nerve roots. It is the displacement, rather the restoration of the disc that explains the mechanisms of the therapeutic effect.%目的:应用生物力学的方法研究推拿手法治疗腰椎间盘突出症的机制。方法:用5具新鲜尸体腰椎在生物力学材料实验机上,在计算机定量控制下模拟不同手法的作用条件,使用引伸仪测量神经根与临近椎间盘之间的位移。结果:3种手法的位移分期为:1.283±0.758m,1.411±0.769mm,1.348±0.774mm。结论:腰椎间盘突出手法推拿的治疗机制是通过神经根相对位移来减轻或消除髓核突出症对神经根的刺激与压迫,松解突出的间盘与神经根两者之间的炎性粘连,是腰椎间盘突出物的"变位"作用,而非髓核的还纳复位。

  12. 棒击法治疗腰椎间盘突出症72例%Treatment on 72 Cases of Lumbar Disc Herniation by Bludgeon-Hit Therapy

    Institute of Scientific and Technical Information of China (English)

    方长友

    2013-01-01

    Objective:To observe the efficacy of bludgeon-hit therapy on lumbar disc herniation. Methods:72 cases of various types of lumbar disc herniation patients were cured by bludgeon-hit therapy, and analyze the efficacy after the treatment. Results:In 72 cases of various types of lumbar disc herniation patients, 54 cases were cured, 16 were effective, the other 2 cases were invalid;the total effective rate was 97.22%. Conclusion:It has significant effect that treat lumbar disc hernia-tion by bludgeon-hit therapy, which is easy to use and worth clinical applying.%  目的:观察棒击法治疗腰椎间盘突出症的疗效.方法:采用棒击法治疗各类型腰椎间盘突出症72例,并分析疗效.结果:72例各类型腰椎间盘突出症患者中,治愈54例,有效16例,无效2例,总有效率97.22%.结论:采用棒击法治疗腰椎间盘突出症临床疗效显著,且简便易行,值得临床推广应用.

  13. Survey of Mechanism Study on Acupuncture Treating Lumbar Disc Herniation%针灸治疗腰椎间盘突出症的机理研究概况

    Institute of Scientific and Technical Information of China (English)

    谢晓龙; 何周欢

    2014-01-01

    Lumbar disc herniation is the clinical common and frequently occurring disease, acupuncture treatment has exact effect, but its mechanism is not completely clear. This paper systemizes literature of functional mechanism of acupuncture treating lumbar disc herniation in recent ten years, and summarizes the possible mechanism of lumbar disc herniation treated with acupuncture, providing a theoretical basis for acupuncture treating lumbar disc herniation.%腰椎间盘突出症是临床常见病、多发病,针灸治疗效果确切,但其作用机理尚未完全明确。本文整理近十年针灸治疗腰椎间盘突出症作用机理的文献,总结针灸治疗腰椎间盘突出症可能的作用机理,为针灸治疗腰椎间盘突出症提供理论依据。

  14. Efficacy Observation on Massage Therapy Treating 40 Cases of Lumbar Disc Herniation%推拿手法治疗腰椎间盘突出症40例疗效观察

    Institute of Scientific and Technical Information of China (English)

    周伟花

    2013-01-01

    Objective:To observe the clinical effects of massage therapy treating lumbar disc herniation. Methods:Massage therapy was implemented to treat patients diagnosed with lumber disc herniation. Results:Among 40 cases of patients with lumbar disc herniation, 22 cases were cured, with 9 cases effective, 7 cases improved and 2 cases ineffective, the total effective rate was 96.92%. Conclusion:The curative effects of massage therapy treating lumbar disc herniation are excellent, without much pain and complications.%  目的:观察推拿手法治疗腰椎间盘突出症的临床效果。方法:对确诊的腰椎间盘突出症患者施行推拿手法治疗。结果:40例腰椎间盘突出患者中,痊愈22例,显效9例,好转7例,无效2例,总有效率为96.92%。结论:应用推拿手法治疗腰椎间盘突出症痛苦小、无并发症,疗效好。

  15. 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.

  16. Magnetic resonance imaging of the cervical spine: Frequency of degenerative changes in the intervertebral disc with relation to age

    Energy Technology Data Exchange (ETDEWEB)

    Abdulkarim, J.A.; Dhingsa, R.; Finlay, D.B.L

    2003-12-01

    AIM: To ascertain the level at which intervertebral disc degeneration of the cervical spine most commonly occurs in each decade from 20-79 years. MATERIALS AND METHODS: Using computer analysis, we retrospectively assessed the mean signal intensity from each cervical disc from T2-weighted spin-echo images in 60 symptomatic patients (10 per decade from the third to eighth inclusive). RESULTS: Age, disc level and interaction between age and level were highly significant predictors for the magnetic resonance imaging (MRI) mean signal intensity from intervertebral discs (p<0.0001 for all three terms). The MRI signals were generally lower as age increased and also for the higher discs (C2-C3, etc). CONCLUSION: In our study we have shown that in younger patients the higher discs are more frequently affected by degeneration than the lower ones. As age increases, the process of degeneration becomes more generalized with less variability between discs.

  17. Herniated Lumbar Disc

    Science.gov (United States)

    ... made of a tough outer layer called the "annulus fibrosus" and a gel-like center called the " ... clearly, sometimes it is necessary to remove a small portion of the lamina, the bone behind the ...

  18. 人工颈椎间盘的假体结构及应用特点%Prosthesis structure and application features of artificial cervical disc

    Institute of Scientific and Technical Information of China (English)

    颜端国

    2014-01-01

    herniation, the surgical therapy. 200 literatures and 56 literatures were respectively searched in CNKI and the PubMed. Titles and abstracts were read. A total of 40 literatures were in accordance with inclusion criteria and included. RESULTS AND CONCLUSION:Artificial cervical disc prosthesis was consistent with physiological functions of intervertebral disk. The material is characterized by abrasion, fatigue resistance and corrosion resistance, is similar to physiological and biomechanical function of human disc, maintains the stability of the spine and motor function, and avoids the accelerated degeneration of adjacent segments. Articles mainly introduced the structure of Bryan, Mobi-C, PCM, Prodisc-C, Prestige and CerviCore artificial cervical disc. Short-period therapeutic effects of artificial cervical disc replacement have obtained approval. However, it cannot completely replace anterior cervical fusion, but is another manner to treat cervical degenerative disc disease.

  19. 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.

  20. 腰间盘突出症的手术与非手术治疗%With the non operative treatment of lumbar disc herniation surgery

    Institute of Scientific and Technical Information of China (English)

    刘向阳; 杨宝来; 张辉

    2016-01-01

    目的:观察腰间盘突出症的手术与非手术治疗的疗效。方法选取2012年12月~2014年12月我院收治的腰间盘突出症患者300例作为研究对象,根据患者意愿,将其分为手术组和非手术组,各150例。分析对比两组患者的治疗总有效率。结果手术组的治疗总有效率为100.00%(150/150),非手术组为76.00%(114/150),差异有统计学意义(P<0.05)。结论对于患者来说,选择非手术治疗可以达到良好的治疗疗效,选择手术治疗时,应尽量选择对脊柱稳定性影响小的手术方法。%Objective With the non operative treatment of lumbar disc herniation surgery to observe the effect of.Methods This study selected in our hospital 300 cases of lumbar disc herniation patients (December December 2012~2014) will be divided into operation group and non operation group. Analysis and comparison of the two groups of patients with the total effective rate of treatment.Result The total effective rate was 100% (150/150) and 76% (114/150) in the surgery group (P<0.05).Conclusion For the patients with lumbar disc herniation, choose non surgical treatment can achieve good therapeutic effect, the choice of surgical treatment, should try to choose a small surgical methods infl uence on the stability of the spine.

  1. 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

  2. The Incidence of Adjacent Segment Degeneration after Cervical Disc Arthroplasty (CDA): A Meta Analysis of Randomized Controlled Trials

    OpenAIRE

    Baohui Yang; Haopeng Li; Ting Zhang; Xijing He; Siyue Xu

    2012-01-01

    BACKGROUND: Cervical disc arthroplasty is being used as an alternative degenerative disc disease treatment with fusion of the cervical spine in order to preserve motion. However, whether replacement arthoplasty in the spine achieves its primary patient centered objective of lowering the frequency of adjacent segment degeneration is not verified yet. METHODOLOGY: We conducted a meta-analysis according to the guidelines of the Cochrane Collaboration using databases including PubMed, Cochrane Ce...

  3. Percutaneous Discectomy Combined with Radiofrequency Ablation with Disc-FX for Contained Lumbar Disc Herniation: 36 Cases Report and 1-year Follow-up%Disc-FX系统治疗包容性腰椎间盘突出症疗效观察

    Institute of Scientific and Technical Information of China (English)

    隰建成; 马远征; 胡明; 崔旭; 赵文亮; 穆小静; 白一冰

    2012-01-01

    Objective To investigate short-term effect of percutaneous discectomy combined with radiofrequency ablation with Disc-FX on contained lumbar disc herniation. Methods 36 patients were reviewed and followed up with Japanese Orthopaedic Association score (JO A score), the Visual Analogue Score (VAS) and Oswestry score for 12 months. Results The scores of JO A score, VAS and Oswestry improved significantly (P<0.01) after operation. Conclusion Percutaneous discectomy combined with radiofrequency ablation with Disc-FX is effective on contained lumbar disc herniation.%目的 探讨Disc-FX系统经皮腰椎髓核摘除、射频消融术治疗包容性腰椎间盘突出症的近期疗效.方法 对36例患者进行回顾性分析.结果 36例患者术后JOA评分系统评分、视觉模拟评分(VAS)及疼痛功能指数评分(Oswestry2.0)较术前明显改善(P<0.01).结论 Disc-FX系统是治疗包容性腰椎间盘突出症的有效方法.

  4. 腰椎间盘突出症的物理治疗与康复%Physical and Rehabilitation Treatment of Lumbar Disc Herniation

    Institute of Scientific and Technical Information of China (English)

    岳寿伟

    2006-01-01

    @@ 1定义 腰椎间盘突出症(Lumbar Disc Herniation,LDH)是指腰椎,尤其是L4~5、L5~S1、L3~4的纤维环破裂和髓核组织突出压迫和刺激相应水平的一侧和双侧坐骨神经所引起的一系列症状和体征.在腰椎间盘突出症的患者中,L4~5、L5~S1突出占90%以上.

  5. The Effects of Stretching with Lumbar Traction on VAS and Oswestry Scales of Patients with Lumbar 4-5 Herniated Intervertebral Disc.

    Science.gov (United States)

    Yang, Hae-Sun; Yoo, Won-Gyu

    2014-07-01

    [Purpose] This study investigated the effect of stretching with lumbar traction on VAS and Oswestry scale scores of lumbar 4-5 herniated intervertebral disc (HIVD) patients. [Subjects] We recruited 20 lumbar 4-5 HIVD patients. [Methods] We performed stretching with lumbar traction for lumbar 4-5 HIVD patients during 4 weeks. The VAS and Oswestry scales were measured before and 4 weeks after the intervention. [Results] The results showed a significant decrease in VAS scale scores for stretching with lumbar traction in lumbar 4-5 HIVD patients, from 18±1.29 to 2.1±1.35. The Oswestry scale scores also decreased significantly, from 20.35±2.01 to 3.5±2.84, after stretching with lumbar traction. [Conclusion] Thus, we suggest stretching with lumbar traction for lumbar 4-5 HIVD patients.

  6. Autotraction in lumbar disc herniation with CT examination before and after treatment, showing no change in appearance of the herniated tissue

    Energy Technology Data Exchange (ETDEWEB)

    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.

  7. 有限手术治疗多节段腰椎问盘突出症%Limited operative treatment for multisegmental lumbar disc herniation

    Institute of Scientific and Technical Information of China (English)

    侯忠学; 赵耘; 许冰; 彭晓; 张勇

    2009-01-01

    目的 探讨多节段腰椎问盘突出症的临床诊断要点及有限手术治疗多节段腰椎间盘突出症的临床疗效.方法 回顾分析我院2000年3月~2007年5月共用多节段开窗加神经根管减压的有限手术治疗多节段腰椎问盘突出症124例,全部病例术前均行X线片、CT或MRI检杏报告腰椎问盘多节段突出,临床体征与影像学报告相一致.术后平均5.6年经腰椎X线动力位片判定脊柱的稳定性,疗效按NAKAI标准进行术前、术后对比.结果 1124例均获随访8个月~7年,平均5.6年,疗效评定为:优68例、良37例、可17例、差2例,总优良率达84.7%.所有病例除有1例并发腰椎问盘突出症复发及2例并发椎间隙感染外,其余均无近期严熏并发症出现,也无腰椎失稳现象发生.结论 多节段开窗的有限手术能在直视下切除椎间盘,彻底地松解神经根并维持脊柱的稳定性,最人程度地减少并发症的发生,是治疗多节段腰椎问盘突出症的有效和可靠方法 .%Objective To explore the clinica diagnosis of multisegmental lumbar disc herniationand the clinical effect of limited operative treatment for multiseg-mental lumbar disc herniation.Methods To retrospectively analyze clinical data of 124 cases with multisegmental,lumbar ,disc herniation treated by limited operation of multiole segmental fenestration plus foraminal stenosis decompression in our hospital during March 2000-May 2007.All the cases were diagnosed as multisegmental lumbar disc herniation by X-ray,CT or MRI before operation,whose clinical signs were accord-ant with radlologic findings .The stability of spinal was assessed by lumbar dynamics position X-ray film averaged 5.6 years after operation.The clinical assessment before and after the therapy was based on NAKAI standard. Results All 124 cases were fol- lowed up for 8 months-7 years,a mean time of 5.6 years.The results were excellent in 68 cases good in 37,fair in 17 and poor in 2,the

  8. 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 .

  9. Surgical management of recurrent disc herniations with microdiscectomy and long-term results on life quality: Detailed analysis of 70 cases

    Science.gov (United States)

    Albayrak, Serdal; Ozturk, Sait; Durdag, Emre; Ayden, Ömer

    2016-01-01

    Background: Aim of this paper is to recall the surgical technique used in the recurrent lumbar disc herniations (LDHs) and to share our experiences. Materials and Methods: Out of series of 1115 patients who underwent operations for LDH between 2006 and 2013, 70 patients underwent re-operations, which were included in this study. During surgery, lateral decompression performed over the medial facet joint to the superior facet joint border was seen after widening the laminectomy defect, and microdiscectomy was performed. The demographic findings of the patients, their complaints in admission to hospital, the level of operation, the condition of dural injury, the first admission in the prospective analysis, and their quality of life were evaluated through the Oswestry scoring during their postoperative 1st, 3rd, 6th-month and 1st, 3rd, 5th and 7th-year follow-up. In the statical analysis, Friedman test was performed for the comparison of the Oswestry scores and Siegel Castellan test was used for the paired nonparametrical data. A P < 0.05 was considered statistically significant. Results: Considering the Oswestry Index during the follow-ups, the values in the postoperative early period and follow-ups were seen to be significantly lower than those at the time of admission to hospital (P < 0.05). None of the patients, who re-operated by microdiscectomy, presented with iatrogenic instability in 7 years follow-up period. Conclusion: Microdiscectomy performed through a proper technique in the re-operation of recurrent disc herniations eases complaints and improves the quality of life. Long-term follow-ups are required for more accurate results. PMID:26933352

  10. Surgical management of recurrent disc herniations with microdiscectomy and long-term results on life quality: Detailed analysis of 70 cases

    Directory of Open Access Journals (Sweden)

    Serdal Albayrak

    2016-01-01

    Full Text Available Background: Aim of this paper is to recall the surgical technique used in the recurrent lumbar disc herniations (LDHs and to share our experiences. Materials and Methods: Out of series of 1115 patients who underwent operations for LDH between 2006 and 2013, 70 patients underwent re-operations, which were included in this study. During surgery, lateral decompression performed over the medial facet joint to the superior facet joint border was seen after widening the laminectomy defect, and microdiscectomy was performed. The demographic findings of the patients, their complaints in admission to hospital, the level of operation, the condition of dural injury, the first admission in the prospective analysis, and their quality of life were evaluated through the Oswestry scoring during their postoperative 1st, 3rd, 6th-month and 1st, 3rd, 5th and 7th-year follow-up. In the statical analysis, Friedman test was performed for the comparison of the Oswestry scores and Siegel Castellan test was used for the paired nonparametrical data. A P < 0.05 was considered statistically significant. Results: Considering the Oswestry Index during the follow-ups, the values in the postoperative early period and follow-ups were seen to be significantly lower than those at the time of admission to hospital (P < 0.05. None of the patients, who re-operated by microdiscectomy, presented with iatrogenic instability in 7 years follow-up period. Conclusion: Microdiscectomy performed through a proper technique in the re-operation of recurrent disc herniations eases complaints and improves the quality of life. Long-term follow-ups are required for more accurate results.

  11. Analysis and treatment of surgical complications after percutaneous transforaminal endoscopic discectomy for treating lumbar disc herniation and lumbar intervertebral foraminal stenosis

    Directory of Open Access Journals (Sweden)

    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

  12. 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.

  13. The DQB1 *03:02 HLA haplotype is associated with increased risk of chronic pain after inguinal hernia surgery and lumbar disc herniation.

    Science.gov (United States)

    Dominguez, Cecilia A; Kalliomäki, Maija; Gunnarsson, Ulf; Moen, Aurora; Sandblom, Gabriel; Kockum, Ingrid; Lavant, Ewa; Olsson, Tomas; Nyberg, Fred; Rygh, Lars Jørgen; Røe, Cecilie; Gjerstad, Johannes; Gordh, Torsten; Piehl, Fredrik

    2013-03-01

    Neuropathic pain conditions are common after nerve injuries and are suggested to be regulated in part by genetic factors. We have previously demonstrated a strong genetic influence of the rat major histocompatibility complex on development of neuropathic pain behavior after peripheral nerve injury. In order to study if the corresponding human leukocyte antigen complex (HLA) also influences susceptibility to pain, we performed an association study in patients that had undergone surgery for inguinal hernia (n=189). One group had developed a chronic pain state following the surgical procedure, while the control group had undergone the same type of operation, without any persistent pain. HLA DRB1genotyping revealed a significantly increased proportion of patients in the pain group carrying DRB1*04 compared to patients in the pain-free group. Additional typing of the DQB1 gene further strengthened the association; carriers of the DQB1*03:02 allele together with DRB1*04 displayed an increased risk of postsurgery pain with an odds risk of 3.16 (1.61-6.22) compared to noncarriers. This finding was subsequently replicated in the clinical material of patients with lumbar disc herniation (n=258), where carriers of the DQB1*03:02 allele displayed a slower recovery and increased pain. In conclusion, we here for the first time demonstrate that there is an HLA-dependent risk of developing pain after surgery or lumbar disc herniation; mediated by the DRB1*04 - DQB1*03:02 haplotype. Further experimental and clinical studies are needed to fine-map the HLA effect and to address underlying mechanisms.

  14. 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.

  15. Clinical Observation on Treatment of Lumbar Intervertebral Disc Herniation with Electroacupuncture on Jiaji (Ex-B 2) Points plus Traction: A Clinical Report of 30 Cases

    Institute of Scientific and Technical Information of China (English)

    穆敬平; 程建明; 敖金波; 王军; 赵大贵

    2007-01-01

    Objective: To investigate the clinical efficacy of treating herniation of lumbar intervertebral disc with electroacupuncture on Jiaji(Ex-B 2) points plus 3-D traction. Methods: To allocate 90 cases randomly into three groups and adopt therapies of 3-D traction, electroacupuncture on Jiaji(Ex-B 2) points and comprehensive method (combination of electroacupuncture on Jiaji(Ex-B 2) points and 3-D traction) and then compare the pre-treatment and post-treatment result with scores of clinical symptoms and clinical efficacy. Results: After 4-week treatment, the group of comprehensive therapy showed better effect than the other two groups. Conclusions:Electroacupuncture on Jiaji(Ex-B 2) points plus 3-D traction has positive effect on herniation of lumbar intervertebral disc.%目的:探讨夹脊电针配合三维牵引治疗腰椎间盘突出症的临床疗效.方法:将90例腰椎间盘突出症患者随机分为3组,分别采用三维牵引、夹脊电针和综合治疗(夹脊电针加三维牵引),采用临床症状积分和临床疗效进行治疗前后比较.结果:治疗4星期后综合组在临床症状积分和临床疗效均优于其他两组.结论:夹脊电针配合三维牵引治疗腰椎间盘突出症的疗效肯定.

  16. 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.

  17. Structural and Ultrastructural Analysis of the Cervical Discs of Young and Elderly Humans.

    Directory of Open Access Journals (Sweden)

    Ricardo Braganca de Vasconcellos Fontes

    Full Text Available Several studies describing the ultrastructure and extracellular matrix (ECM of intervertebral discs (IVDs involve animal models and specimens obtained from symptomatic individuals during surgery for degenerative disease or scoliosis, which may not necessarily correlate to changes secondary to normal aging in humans. These changes may also be segment-specific based on different load patterns throughout life. Our objective was to describe the ECM and collagen profile of cervical IVDs in young (G1 - 65 years presumably-asymptomatic individuals. Thirty cervical discs per group were obtained during autopsies of presumably-asymptomatic individuals. IVDs were analyzed with MRI, a morphological grading scale, light microscopy, scanning electron microscopy (SEM and immunohistochemistry (IHC for collagen types I, II, III, IV, V, VI, IX and X. Macroscopic degenerative features such as loss of annulus-nucleus distinction and fissures were found in both groups and significantly more severe in G2 as expected. MRI could not detect all morphological changes when compared even with simple morphological inspection. The loose fibrocartilaginous G1 matrix was replaced by a denser ECM in G2 with predominantly cartilaginous characteristics, chondrocyte clusters and absent elastic fibers. SEM demonstrated persistence of an identifiable nucleus and Sharpey-type insertion of cervical annulus fibers even in highly-degenerated G2 specimens. All collagen types were detected in every disc sector except for collagen X, with the largest area stained by collagens II and IV. Collagen detection was significantly decreased in G2: although significant intradiscal differences were rare, changes may occur faster or earlier in the posterior annulus. These results demonstrate an extensive modification of the ECM with maintenance of basic ultrastructural features despite severe macroscopic degeneration. Collagen analysis supports there is not a "pathologic" collagen type and changes

  18. 腰骶部移行椎与腰椎间盘突出症的关系%Relationship between lumbosacral transitional vertebra and lumbar disc herniation

    Institute of Scientific and Technical Information of China (English)

    孔德茂; 陈伯华; 胡有谷; 马学晓; 张国庆; 岳斌; 相宏飞

    2014-01-01

    Background:At present, the relationship between lumbosacral transtional vertebra and lumbar intervertebral disc herniation has been unclear. Objective: To investigate the relationship between lumbosacral transtional vertebra and lumbar intervertebral disc hernia-tion, and the influence of transitional vertebra on lumbar disc re-herniation. Methods:The present study included three groups. There were 193 patients in groupⅠ, including 111 with lumbosacral trans-tional vertebrae and 82 without lumbosacral transitional vertebrae, who underwent primary surgical treatment for lumbar disc herniation from June 2008 to August 2010. There were 220 healthy controls who took physical examination in our hospi-tal in groupⅡ. There were 33 patients with revision surgery for lumbar disc herniation from April 2004 to August 2010 in groupⅢ, including 18 cases with lumbosacral transtional vertebrae and 15 without lumbosacral transitional vertebrae. The in-cidence and the type of lumbosacral transitional vertebrae by imaging examination were recorded in the three groups. The re-lationship between the position of lumbar disc herniation and lumbosacral transtional vertebrae was investigated. Results:The incidence of lumbosacral transitional vertebrae was respectively 57.51%, 51.82%and 54.55%in groupⅠ,Ⅱand Ⅲ, and there was no significant difference between groups (χ2=1.34, P>0.05). The incidence of CastellviⅠ was 38.86%, 45.00% and 36.36%, respectively in group Ⅰ, Ⅱ and Ⅲ(χ2=2.01, P>0.05). The incidence of CastellviⅡ was 12.95%, 4.55%and 15.15%, there was significant difference between groupⅠand groupⅡ(χ2=9.35, P0.05). The incidence of CastellviⅢwas 5.18%, 2.27%and 0 in groupⅠ,ⅡandⅢ(χ2=3.92, P>0.05). The incidence of CastellviⅣwas 0.52%, 0 and 3.03%in groupⅠ,ⅡandⅢ(χ2=5.94, P>0.05). In groupⅠ, the incidence of lumbar intervertebral disc herniation was 71.17%at L4~5 seg-ments and 26.13%at L5~S1 segments in patients with lumbosacral

  19. 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

  20. Effects of Ge Gen Decoction on PGE2 Content and COX Activity in the Degenarated Cervical Intervertebral Discs of Rats

    Institute of Scientific and Technical Information of China (English)

    Zhou Jun; Fang Suping; Huo Hairu; Qi Yun; Guo Shuying; Jiang Tingliang; Shi Qi; Wang Youjing

    2005-01-01

    After the rat model of cervical spondylosis was developed for 6 months, the PGE2 content and COX activity in the cervical intervertebral discs were determined respectively by radioimmunoassay and catalytic activity assay.The results indicated that the PGF2 content and COX activity in the model rat increased significantly, and that Ge Gen Decoction could down-regulate the PGE2 content and inhibit COX activity. This is possibly one of the mechanisms of Ge Gen Decoction for treating cervical spondylosis.

  1. Kinematic MR imaging in surgical management of cervical disc disease, spondylosis and spondylotic myelopathy

    Energy Technology Data Exchange (ETDEWEB)

    Muhle, C.; Metzner, J.; Brinkmann, G.; Heller, M. [Christian-Albrechts-Universitaet, Kiel (Germany). Dept. of Diagnostic Radiology; Weinert, D.; Schoen, R.; Rautenberg, E.; Mehdorn, H.M. [Christian-Albrechts-Universitaet, Kiel (Germany). Dept. of Neurosurgery; Falliner, A. [Christian-Albrechts-Universitaet, Kiel (Germany). Dept. of Orthopedics; Resnick, D. [Veterans Affairs Medical Center, San Diego, CA (United States). Dept. of Radiology

    1999-03-01

    Purpose: To estimate the clinical value and influence of kinematic MR imaging in patients with degenerative diseases of the cervical spine. Material and methods: Eighty-one patients were examined with a 1.5 T whole body magnet using a positioning device. Cervical disc disease was classified according to clinical and radiographic findings into 4 stages: stage I=cervical disc disease (n=13); stage II=spondylosis (n=42); stage III=spondylosis with restricted motion (n=11); and stage IV-cervical spondylotic myelopathy (n=15). Findings on kinematic MR images were compared to those on flexion and extension radiographs, myelography, CT-myelography and static MR imaging. Furthermore, the influence of kinematic MR imaging on surgical management and intra-operative patient positioning was determined. Results: Additional information obtained by kinematic MR imaging changed the therapeutic management in 7 of 11 (64%) patients with stage III disease, and in 13 of 15 (87%) patients with stage IV disease. Instead of an anterior approach, a posterior surgical approach was chosen in 3 of 11 patients (27%) with stage III disease and in 6 of 15 patients (40%) with stage IV disease. Hyperextension of the neck was avoided intra-operatively in 4 patients (27%) with cervical spondylotic myelopathy, and in 1 patient with stage II (2%) and in 1 patient with stage III (9%) disease. Kinematic MR imaging provided additional information in all patients with stages III and IV disease except in 1 patient with stage III disease, when compared to flexion and extension radiographs, myelography, CT-myelography and static MR examination. Conclusion: Kinematic MR imaging adds additional information when compared to conventional imaging methods in patients with advanced stages of degenerative disease of the cervical spine. (orig.)

  2. 氟骨症对腰椎间盘突出患者腰椎骨密度的影响%Effect of skeletal fluorosis on the bone mineral density of patients with lumbar disc herniation

    Institute of Scientific and Technical Information of China (English)

    栗平; 王兴国; 王长海

    2015-01-01

    Objective To study the status of bone mineral density ( BMD) in skeletal fluorosis patients with lumbar intervertebral disc herniation, in order to provide scientific basis for early prevention of lumbar disc herniation and osteoporosis in fluorosis patients.Methods BMD between patients with lumbar disc herniation ( 61 patients with fluorosis and 1149 patients without fluorosis) and 400 healthy controls were compared.Results BMD in disc herniation patients with fluorosis was significantly different comparing to that in healthy controls.BMD decreased in disc herniation patients without fluorosis comparing to that in healthy controls, but the difference was not statistically significant.Conclusion Early diagnosis and treatment of fluorosis is important for prevention of lumbar disc herniation and osteoporosis.%目的:研究氟骨症患者的腰椎间盘突出及其腰椎骨密度状况,为氟骨症患者早期预防腰间盘突出及骨质疏松提供科学的依据。方法对61例合并有氟骨症和1149例无氟骨症的腰椎间盘突出患者腰椎骨密度与400例健康对照组腰椎骨密度进行比较。结果合并有氟骨症的腰椎间盘突出患者与健康对照组腰椎骨密度差异有显著性,具有统计学意义,不合并有氟骨症的腰椎间盘突出患者较健康对照组腰椎骨密度减少,但差异无统计学意义。结论氟骨症的早期诊治对预防腰椎间盘突出及骨质疏松有重要意义。

  3. Clinical Observation of Comprehensive Therapy in the Treatment of Lumbar Disc Herniation in 75 Ca-ses%综合疗法治疗腰间盘突出症75例的临床观察

    Institute of Scientific and Technical Information of China (English)

    李丙男

    2016-01-01

    目的:使用综合疗法对腰椎间盘突出患者进行治疗,明确腰椎间盘突出症综合疗法的临床疗效,为其一线的临床推广应用提供科学合理的依据。方法采用综合疗法对腰椎间盘患者进行治疗并对其临床疗效进行观察及评价。结果39例患者治愈,22例患者显著进步,11例患者好转,无效患者共3例,患者的总有效率为96%。结论综合疗法治疗腰间盘突出症是理想的治疗腰间盘突出症的方法并值得临床推广。%Objective To use combination therapy for the treatment of patients with lumbar disc herniation, clear the clinical curative effect of lumbar disc herniation combined therapy, clinical application of the line to provide scientific and reasonable basis.Methods To observe and evaluate the clinical curative effect of the treatment of lumbar interver-tebral disc with comprehensive therapy.Results 39 cases were cured, 22 cases improved, 11 cases improved, 3 cases invalid, the total effective rate was 96%.Conclusions Combined therapy in the treatment of lumbar disc herniation is a ideal method for the treatment of lumbar disc herniation and is worthy of promotion.

  4. ProDisc-C人工椎间盘双节段置换治疗重症颈椎病%ProDisc-C cervical disc two-segment replacement from severe cervical spondylosis

    Institute of Scientific and Technical Information of China (English)

    曾云; 熊敏; 余化龙; 何宁; 王志勇; 刘志刚; 韩珩; 陈森; 郭乐运

    2013-01-01

    Objective To investigate the clinical effect of ProDisc-C cervical disc replacement for two-segment severe cervical spondylosis.Methods Seventeen cases of two-segment severe cervical spondylosis aged from 36-59 years old were treated with artificial cervical disc replacement.The patients were followed up for 24 to 55 months after operation.The visual analogue scale (VAS),Japanese Orthopedic Association (JOA) scores,cervical curvature overall and the range of motion of the replacement segment were evaluated pre-and 3,12 and 24 months post-operation.Results The VAS scores at 3,12 and 24 months post-operation were 3.8 ± 1.9,1.9 ± 0.8 and 1.1 ± 0.4 respectively,which were significantly reduced as compared with pre-operation (6.3 ± 2.7,P < 0.05).The JOA scores at 3,12 and 24 months postoperation were 13.4 ± 1.5,15.2 ± 1.1 and 15.9 ± 1.4 respectively,which were significantly increased as compared with pre-operation (8.7 ± 2.1,P < 0.05).There was no statistically significant difference in the cervical curvature overall before and 24 months after operation (P > 0.05).There was significant difference in the range of motion of the replacement segmentl before and 24 months after operation (P < 0.05).Conclusion The clinical effect of ProDisc-C cervical disc replacement for two-segment severe cervical spondylosis is satisfactory and it can maintain good cervical activity after operation.%目的 观察ProDisc-C人工椎间盘置换治疗双节段重症颈椎病的疗效.方法 对17例双节段重症颈椎病患者进行人工椎间盘置换术,年龄36~59岁,术后随访时间24 ~55个月,手术前后观察视觉模拟评分(VAS)、JOA评分、颈椎整体曲度、置换节段活动度.结果 术后第3、12、24个月VAS评分分别为(3.8±1.9)、(1.9±0.8)、(1.1±0.4)分,与术前(6.3±2.7)分比较差异有统计学意义(P<0.05);术后第3、12、24个月JOA评分分别为(13.4±1.5)、(15.2±1.1)、(15.9±1.4)分,与术前(8.7±2.1)分比

  5. Modelo experimental para o estudo da hérnia do disco intervertebral Experimental model to study intervertebral disc herniation

    Directory of Open Access Journals (Sweden)

    André Luiz de Souza Grava

    2008-04-01

    Full Text Available OBJETIVO: Apresentar um modelo experimental de hérnia de disco e sua validação para estudo da hiperalgesia mecânica e térmica produzidas pelo contato do núcleo pulposo (NP com as estruturas nervosas envolvidas nessa afecção. MÉTODOS: Foram utilizados ratos Wistar, sendo o NP autólogo retirado da região sacrococcígea e depositado sobre a dura-máter, raiz nervosa ou gânglios das raízes dorsais L4, L5 ou L6. Os experimentos foram divididos em quatro etapas: 1ª determinação da estrutura nervosa mais sensível ao contato com o NP; 2ª identificação do melhor nível lombar para a indução da hiperalgesia; 3ª determinação da ausência de lesão motora; e 4ª determinação da influência do procedimento cirúrgico no desenvolvimento do processo inflamatório. A hiperalgesia foi avaliada nos testes de von Frey eletrônico e de Hargreaves e a função motora, pelo teste de rota-rod. RESULTADOS: O NP induziu hiperalgesia de maior intensidade na pata quando em contato com o gânglio da raiz dorsal (GRD do que em contato com a dura-máter ou a raiz nervosa. Quando em contato com o GRD-L5, o NP induziu hiperalgesia ainda maior que a induzida pelo contato com os GRDs L4 e L6. Não foram observadas lesão motora e influência do processo inflamatório cirúrgico sobre a hiperalgesia. CONCLUSÃO: O GRD é a estrutura mais sensível aos componentes do NP para a produção da hiperalgesia, sendo o quinto nível lombar o que apresentou maior alteração nas sensibilidades mecânica e térmica avaliadas na pata dos animais, de acordo com os métodos utilizados.OBJECTIVE:The purpose of this study is to present an experimental model of disc herniation and to validate such model to study mechanic and thermal hyperalgesia produced by the contact of the nucleus pulposus (NP with nerve structures involved in this condition. METHODS: The authors used Wistar rats, the autologous NP being removed from the sacrococcygeal region and deposited on the

  6. The Strategy and Early Clinical Outcome of Percutaneous Full-Endoscopic Interlaminar or Extraforaminal Approach for Treatment of Lumbar Disc Herniation.

    Science.gov (United States)

    Kong, Weijun; Liao, Wenbo; Ao, Jun; Cao, Guangru; Qin, Jianpu; Cai, Yuqiang

    2016-01-01

    Objective is to analyze the surgical strategy, safety, and clinical results of percutaneous full-endoscopic discectomy through interlaminar or extraforaminal puncture technique for LDH. Preoperative CT and MRI were analyzed, which were based on the main location of the herniated disc and its relationship with compressed nerve root. Sixty-two patients satisfied the inclusion criteria during the period from August 2012 to March 2014. We use percutaneous full-endoscopic discectomy through different puncture technique to remove the protrusive NP for LDH. Sixty patients completed the full-endoscopic operation successfully. Their removed disc tissue volume ranged from 1.5 mL to 3.8 mL each time. Postoperative ODI and VAS of low back and sciatica pain were significantly decreased in each time point compared to preoperative ones. No nerve root injury, infection, and other complications occurred. The other two patients were shifted to open surgery. No secondary surgery was required and 91.6% of excellent-to-good ratio was achieved on the basis of Macnab criteria at postoperative 12 months. Acquired benefits are fewer complications, rapid recovery, complete NP removal, effective nerve root decompression, and satisfactory cosmetic effect as well. This is a safe, effective, and rational minimally invasive spine-surgical technology with excellent clinical outcome.

  7. The Strategy and Early Clinical Outcome of Percutaneous Full-Endoscopic Interlaminar or Extraforaminal Approach for Treatment of Lumbar Disc Herniation

    Directory of Open Access Journals (Sweden)

    Weijun Kong

    2016-01-01

    Full Text Available Objective is to analyze the surgical strategy, safety, and clinical results of percutaneous full-endoscopic discectomy through interlaminar or extraforaminal puncture technique for LDH. Preoperative CT and MRI were analyzed, which were based on the main location of the herniated disc and its relationship with compressed nerve root. Sixty-two patients satisfied the inclusion criteria during the period from August 2012 to March 2014. We use percutaneous full-endoscopic discectomy through different puncture technique to remove the protrusive NP for LDH. Sixty patients completed the full-endoscopic operation successfully. Their removed disc tissue volume ranged from 1.5 mL to 3.8 mL each time. Postoperative ODI and VAS of low back and sciatica pain were significantly decreased in each time point compared to preoperative ones. No nerve root injury, infection, and other complications occurred. The other two patients were shifted to open surgery. No secondary surgery was required and 91.6% of excellent-to-good ratio was achieved on the basis of Macnab criteria at postoperative 12 months. Acquired benefits are fewer complications, rapid recovery, complete NP removal, effective nerve root decompression, and satisfactory cosmetic effect as well. This is a safe, effective, and rational minimally invasive spine-surgical technology with excellent clinical outcome.

  8. Onset of complications following cervical manipulation due to malpractice in osteopathic treatment: a case report.

    Science.gov (United States)

    Cicconi, Michela; Mangiulli, Tatiana; Bolino, Giorgio

    2014-10-01

    The aim of this study is to correlate cervical disc herniation with manipulation performed by a non-physician osteopath on a patient complaining of neck pain. The authors report a case in which a woman - treated with osteopathic spinal manipulation - developed cervical-brachial neuralgia following the cervical disc herniation. The patient then underwent surgery and was followed by physiotherapists. A clinical condition characterized by limitation of neck mobility, with pain and sensory deficit in the right arm and II-III fingers, still persists. The patient consulted the authors to establish whether cervical disc herniation could be attributed to manipulation. Adverse events or side effects of spinal manipulative therapy are relatively common and usually benign. Most of these side effects are mild or moderate, but sometimes they can be severe. Cervical manipulation can provoke complications less often than thoracic or lumbar manipulation. Furthermore, many diseases can be absolutely and relatively contraindicated to osteopathic treatment. Therefore, the knowledge of a patient's clinical conditions is essential before starting a manipulative treatment; otherwise the osteopath could be accused of malpractice. It is the authors' opinion that a cause-effect relationship exists between the manipulative treatment and the development of disc herniation.

  9. 腰椎间盘突出症的CT及MR诊断价值比较分析%Comparative Analysis of Value of CT and MR in Diagnosis of Lumbar Disc Herniation

    Institute of Scientific and Technical Information of China (English)

    袁增清

    2016-01-01

    目的:分析CT及MR诊断腰椎间盘突出症的临床价值。方法随机选择该院2012年5月—2014年9月收治的50例腰椎间盘突出症患者作为观察对象,对50例腰椎间盘突出症患者采用CT及MR检查,CT检查结果作为对照组数据,MR检查结果作为实验组数据,以临床病理检验结果作为金标准,该研究所选患者均为临床病理诊断确诊患者,对比两种检查方式对于诊断腰椎间盘突出症的价值。结果对照组诊断准确率为84.00%,椎间盘突出患者38例,椎间盘脱出4例;实验组诊断准确率为96.00%,椎间盘突出患者42例,椎间盘脱出6例;组间诊断准确率差异有统计学意义(P﹤0.05)。结论针对腰椎间盘突出症患者采用MR检查的诊断价值高于CT检查的诊断价值,MR检查应作为诊断腰椎间盘突出症的首选方式。%Objective To analyze the clinical value of CT and MR in diagnosis of lumbar disc herniation. Methods 50 cas-es of patients with lumbar disc herniation confirmed by clinical pathological diagnosis in our hospital from May 2012 to September 2014 were selected and examined by CT and MR, the CT examination results were regarded as the data of the control group, the MR examination results were regarded as the data of the experimental group, the value of two examination methods in diagnosis of lumbar disc herniation was compared according to the clinical pathological examination results. Re-sults In the control group, the diagnostic accurate rate was 84.00%, 38 cases were with herniated disk, 4 cases were with herniated disc; in the experimental group, the diagnostic accurate rate was 96.00%, 42 cases were with herniated disk, 6 cases were with herniated disc, the difference in the diagnostic accurate rate between the two groups was obvious with sta-tistically significance(P﹤0.05). Conclusion The diagnostic value of MR examination for patients with lumbar disc hernia-tion is higher than that of CT examination, which can

  10. Analysis of the Risk Factors and CT Imaging Features of Lumbar Disc Herniation%腰椎间盘突出症发病危险因素及CT影像特点分析

    Institute of Scientific and Technical Information of China (English)

    柯东港

    2016-01-01

    目的 分析腰椎间盘突出症发病危险因素及CT影像特点.方法 选择经手术病理证实的腰椎间盘突出症患者、同期行健康体检者各50例,分别为观察组与对照组,通过自行设计的流行病学调查表对照分析总结腰椎盘突出症发病危险因素.同时分析不同程度腰椎间盘突出症CT影像特点.结果 多因素及Logistic回归分析,腰椎间盘突出症发病独立危险因素为体质量指数、持续坐位时间、腰部损伤史及弯腰程度.轻度者突出物以弧形边缘光滑为主,髓核脱出或突出,髓核疝密度以≤80为主,1区水平面突出面积大,神经根以紧贴为主;中度、重度者以山丘状边缘不规整为主,髓核脱出为主,髓核疝密度以>100为主,3区水平面突出面积大,神经根受压、紧贴或粘连.结论 体质量指数、持续坐位时间、腰部损伤史及弯腰程度为腰椎间盘突出症发病独立危险因素.腰椎间盘突出症不同严重程度CT影像特点存在较大的区别.%Objective To analyze the risk factors and CT imaging features of lumbar disc herniation.Methods 50 cases of patients with lumbar disc herniation confirmed by operation and pathology were selected as the observation group and another 50 cases of healthy controls were selected as the control group at the same time. According to the self-designed epidemiological questionnaires, the risk factors of lumbar disc herniation were analyzed and summarized and the CT imaging features of lumbar disc herniation of different degrees were also analyzed.Results Multiple and Logistic regression analysis showed that body mass index, continuous sitting time, waist injury history and bending degree were the independent risk factors of lumbar disc herniation. The protrusions in mild patients were with curved edges which were smooth. The nucleus pulposus prolapsed or protruded. The nucleus pulposus herniation density mainly was equal to or less than 80. The protruding area

  11. 归藤红花汤治疗腰椎间盘突出症30例%Treating 30 cases of lumbar disc herniation with the Guiteng Honghua decoction

    Institute of Scientific and Technical Information of China (English)

    周霖

    2013-01-01

    Lumbar disc herniation is one of the main causes of clinical pain in waist and legs. The disease to collateral stasis is the basic pathogenesis, blood stasis, phlegm, Qixu, Shenqi Kuxu, deficiency of liver and kidney and other syndromes. This paper uses to Guiteng Honghua decoction for basic decoction in the treatment of lumbar disc herniation.%腰椎间盘突出症是临床腰腿疼痛的主要原因之一。本病以络脉瘀阻为基本病机,常见血瘀、痰湿、气虚、肾气亏虚、肝肾不足等各种证型。本文采用归藤红花汤为基本方加减治疗腰椎间盘突出症。

  12. 腰椎间盘突出症中医保守治疗的效果分析%Analysis on the efficacy of treating lumbar disc herniation in TCM conservative treatment

    Institute of Scientific and Technical Information of China (English)

    张兵

    2012-01-01

      腰椎间盘突出症主要表现为:腰痛、下肢放射痛、感觉异常等。每于外伤、劳累、受寒、姿势异常等情况下复发加重,严重影响患者的生活质量。本文对中医保守治疗腰椎间盘突出症的具体效果进行分析。%  Lumbar disc herniation mainly displayed as follows: low back pain, sciatica and paresthesia. Seriously affect the quality of life of patients with recurrence increased, every trauma, fatigue, chills, abnormal posture. In this paper, the specific effect of TCM conservative treatment of lumbar disc herniation.

  13. Progress of Research and Treatment for Lumbar Disc Herniation in Juveniles%未成年人腰椎间盘突出症的研究与治疗进展

    Institute of Scientific and Technical Information of China (English)

    宋鹏(综述); 王运涛; 吴小涛(审校)

    2015-01-01

    腰椎间盘突出症在未成年人中较为少见,在诊断与治疗方面具有一定难度。本文从患病率、发病机理与危险因素、病理改变、临床表现以及主要治疗方式与疗效方面对未成年人LDH进行综述,以利于临床诊断与治疗。%[Summary] Lumbar disc herniation is rare in juveniles , which makes it more difficult to diagnose and treat .The prevalence , causes and risk factors , pathological changes , clinical characteristics , main treatment methods , and curative effects of lumbar disc herniation in juveniles were summarized in this review , for benefiting clinical diagnosis and treatment .

  14. 16-Slice CT in the Diagnosis of Lumbar Disc Herniation%16排CT在腰椎间盘突出诊断中的应用

    Institute of Scientific and Technical Information of China (English)

    王浩然

    2015-01-01

    Objective To analyze the 16-slice CT in the diagnosis of lumbar disc herniation. Methods 16-slice spiral CT for patients with traditional disc-level axial scan and full lumbar vertebral full volume scan. Results The diagnosis of L2~L3 segment bulging large differences (P0.05). Conclusion 16-slice spiral CT scanning technology to check lumbar disc is better than traditional scanning technology.%目的:分析16排CT在腰椎间盘突出诊断的应用。方法在诊断患者中使用16排螺旋CT机进行传统椎间盘层面轴位扫描和全腰椎容积扫描,比较诊断的结果。结果诊断L2~L3段膨出差异较大(P<0.05),诊断突出L1~L2、L3~L4、L4~L5、L5~S1段两种扫描方法诊断膨出和突出效果差异较小(P>0.05)。讨论16排螺旋CT扫描技术在检查腰椎间盘突出明显优于传统扫描技术。

  15. 经皮穿刺水刀切吸术治疗颈椎间盘突出症的疗效分析%THE CLINIAL EFFICACY OF PERCUTANEOUS WAYER JET CUTTING AND ASPIPATION ON THE TREATMENT OF CETVICAL DISC HERNIATION

    Institute of Scientific and Technical Information of China (English)

    王文; 杨福生; 刘建英; 单素英; 马俊萍; 孙金子; 康宁超

    2012-01-01

    目的:评估经皮穿刺椎间盘水刀髓核切吸术治疗颈椎间盘突出症的疗效.方法:自2009年2月~ 2011年2月选取符合本组研究标准的颈椎间盘突出症46例,在C型臂X线机、CT、DSA引导下行经皮穿刺颈椎间盘髓核切吸术.观察术后5夭、90夭、180天、360天的疗效.结果:采用Williams方法进行评估,术后5天、90天、180天、360天疗效的优良率分别是82.5%、93.48%、97.83%、97.83%.结论:经皮穿刺椎间盘水刀髓核切吸术治疗颈椎间盘突出症安全、操作流程更快捷、简单,切除的靶点明确、量化.%Objective: To evaluate the clinical efficacy of percutaneous water jet cutting and aspiration on the treatment of cervical disc herniation. Methods: From 2009 February to 2011 February, 46 cases of cervical intervertebral disc protrusion were treated with percutaneous water jet cutting and aspiration guided by C arm X-ray machine, CT and DSA. Using the Williams method, the curative effects were evaluated on 5 d, 90 d, 180 d, 360 d after operation. Results: The excellent and good rates on 5 d, 90 d, 180 d, 360 d after operation were 82.5%, 93.48%, 97.83%, 97.83% respectively. Conclusion: Percutaneous water jet cutting and aspiration was an effective treatment for cervical disc herniation, with the advantage of safty, more efficient, simple, resection of the clear targets, quantization.

  16. 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.

  17. 韦绪性教授治疗腰椎间盘突出症学术思想撷要%Academic thought of Professor WEI Xu-xing for treating lumbar disc herniation

    Institute of Scientific and Technical Information of China (English)

    崔敏

    2014-01-01

    Analysis academic thoughts of Professor WEI Xu-xing from four aspects in treatment of lumbar disc herniation, and study his differentiation therapy through the medical record examples.%从四个方面分析韦绪性教授治疗腰椎间盘突出症的学术思想,通过病案举隅研究其辨证施治要诀。

  18. 整骨类手法治疗腰椎间盘突出症研究概况%Research Survey on Osteopathic Manipulation Treating Lumbar Disc Herniation

    Institute of Scientific and Technical Information of China (English)

    王强; 孙波

    2014-01-01

    Osteopathic manipulation is one of non-operative treatment for lumbar disc herniation, which belongs to traditional treatment method of Chinese medicine with strict requirements of technical specification. At present domestic osteopathic treatment for lumbar disc herniation are vari-ous, such as lumbar rotation reduction method, seat lumbar rotatory pulling manipulation, all kinds of decubitus lumbar rotatory pulling manipula-tion, prone lumbar back-extending pulling manipulation, twisted waist method, supine pulling hyperextension method, stepping lumbus, lumbar back method, rotating manipulation and the like. In this paper various types of osteopathic manipulation for lumbar disc herniation were reviewed and ana-lyzed, in order to provide ideas for the advance of osteopathic manipulation treating lumbar disc herniation clinically.%整骨手法是腰椎间盘突出症的非手术治疗手段之一,属于中医传统治疗方法,有较严格的技术规范要求。目前国内对腰椎间盘突出症的整骨手法治疗多样,如坐位腰椎旋转复位法、坐位腰椎旋转扳法、各式卧位腰椎旋转扳法、俯卧位腰椎后伸扳法、绞腰法、仰扳过伸法、踩跷法、腰椎背法、摇法等。本文将就各类治疗腰椎间盘突出症的整骨类手法进行综述分析,以期为临床治疗腰椎间盘突出症的整骨手法治疗技术的进步提供思路。

  19. 牵引治疗对腰椎间盘突出症患者止血凝血功能的影响%Effect of Traction Treatment on Haemostatic and Coagulation Function of Patients with Lumbar Intervertebral Disc Herniation

    Institute of Scientific and Technical Information of China (English)

    蔡淑锋; 方光辉; 李恩治; 王武琦

    2012-01-01

    Objective: To study the traction treatment on haemostatic and coagulation function in lumbar inter-vertebral disc herniation patients. Methods: Haemostatic and coagulation indicators of 60 lumbar intervertebral disc herniation patients were observed before and after traction treatment. Results: Compared with the normal group, hemostatic indicators in lumbar intervertebral disc herniation patients were no significant differences. After the 1st traction, these indicators were changed remarkably. Compared with the 1st traction, indicators were changed obviously after 1 traction therapy period. Conclusion: Lumbar intervertebral disc herniation patients can be used the fiber degrading treatment and anticoagualnt therapy after they are various degree thrombus.%目的 观察牵引治疗对腰椎间盘突出症患者止血凝血功能的影响.方法 观察60例腰椎间盘突出症患者行牵引治疗前后止凝血指标的变化.结果 治疗组牵引治疗前止血凝血参数与对照组(正常人)相近:治疗组第1次牵引前后比较,各指标差异有统计学意义;与第1次牵引后比较,治疗1个疗程后各指标比较差异有统计学意义.结论 牵引治疗的腰椎间盘突出症患者形成不同程度的血栓,临床可进行降纤和抗凝治疗.

  20. 150 Cases from the Yin Cited Yang Massage Treatment of Lumbar Disc Herniation%从阴引阳法推拿治疗腰椎间盘突出症150例疗效观察

    Institute of Scientific and Technical Information of China (English)

    郑兆俭; 周倩; 陈志瑞; 徐伟伟; 林樯

    2012-01-01

    [Objective]To observe the lead from the Yin to yang massage treatment of lumbar disc herniation. [Methods] 150 cases of lumbar disc herniation were randomly divided into treatment group 75 cases(with the overcast cited'yang massage therapy) and control group (general massage therapy), observed after treatment, the efficacy of treatment before and after the JOA, VAS score, and comparative analysis. [Results]From other yin yang massage treatment of lumbar disc herniation, the JOA score, VAS scores were better than ordinary massage therapy( P< 0.05). [Conclusion]Cited from the Yin yang massage therapy is the treatment of lumbar disc herniation with efficiency.%[目的]观察从阴引阳法推拿治疗腰椎间盘突出症临床疗效.[方法]将腰椎间盘突出症患者150例随机分为治疗组75例(从阴引阳法推拿治疗)与对照组75例(普通推拿治疗),观察治疗后的疗效、治疗前后JOA、VAS评分,并进行对照分析.[结果]从阴引阳法推拿治疗腰椎间盘突出症的疗效、JOA评分、VAS评分均优于普通推拿治疗,P<0.05.[结论]从阴引阳法推拿治疗是治疗腰椎间盘突出症较有为效的方法.

  1. TRANSFORAMINAL CERVICAL NERVE ROOT BLOCK: OUTCOMES AND COMPLICATIONS

    Directory of Open Access Journals (Sweden)

    EMILIANO NEVES VIALLE

    Full Text Available ABSTRACT Objectives: To investigate the effect and complications after transforaminal injection for cervicobrachialgia caused by cervical disc herniation. Methods: We retrospectively reviewed all patients undergoing fluoroscopy-guided transforaminal injection for radiculopathy caused by cervical disc herniation. During the last seven years, 57 patients (39 female, 18 male, mean age 45.6 years experiencing cervical radiculopathy underwent cervical foraminal block guided by fluoroscopy by postero-lateral approach. The position of the needle was verified after injection of a small amount of contrast. A glucocorticosteroid was injected after 0.5 ml of 2% lidocaine. Results: The local with the highest prevalence of procedures was C6 root (31 procedures; 14 patients underwent C7 block, 7 had C5 block, and 5 in C4. Eight patients (14% had complications (3 syncopes, 3 transient hoarseness, one patient had worsening of symptoms and one patient had soft tissue hematoma. In total, 42.1% were asymptomatic after the procedure and therefore did not require surgery after the procedure. Other 57.9% had transient improvement, became asymptomatic for at least 2 months but required surgery due to the recurrence of symptoms. Conclusion: Cervical foraminal block for cervical disc herniation is a safe way to avoid surgery. Some patients still need surgery after the procedure, but the temporary improvement in symptoms gives the patient some relief while awaiting surgery.

  2. 肌电图评价腰椎间盘突出症的临床价值%Clinical values of electromyogram in evaluating lumbar disc herniation

    Institute of Scientific and Technical Information of China (English)

    高庆; 方诗元

    2011-01-01

    BACKGROUND: Electromyogram (EMG) provides an objective appreciation in diagnosis, treatment selection and evaluation of curative effect for patients with lumbar disc herniation (LDH), and has an objective, accurate and quantitative role in assessment of recovery in nerve lesions.OBJECTIVE: To summarize the roles of EMG in diagnosis, and evaluation of curative effect for patients with LDH.METHODS: A compute-based online search of Pubmed database (1990-01/2010-10) and CNKI (1998-01/2010-10) was performed with key words "LDH, sEMG, EMG, lumbar disc herniation" in English and "LDH, electromyography" in Chinese. The articles about LDH and EMG were included. Repeated studies were excluded.RESULTS AND CONCLUSION: A total of 34 literatu res were included and analyzed the roles of EMG in diagnosis, and evaluation of curative effect for patients with LDH. Routine EMG has objective effects on diagnosis, evaluation of curative effect and selection of treatment methods, and surface EMG also plays similar roles. But surface EMG is easily interfered. Therefore, extensive clinical application of surface EMG requires further investigation.%背景:肌电图对腰椎间盘突出症患者的诊断、治疗方法选择及治疗效果有客观的评价作用,并且在神经病变恢复的评定中具有客观、准确、定量等的作用.目的:总结近年来肌电图在腰椎间盘突出患者诊断、治疗方法效果评定中所起的作用.方法:以LDH,Lumbar disc herniation,sEMG,EMG为检索词,检索Pubmed数据库(1990-01/2010-10),以腰椎间盘突出症,肌电图为检索词,检索中国期刊全文数据库(1998-01/2010-10),文献检索语种限制为英文和中文.纳入肌电图及腰椎间盘突出症相关的内容.排除重复性研究.结果与结论:通过34篇文献对肌电图在腰椎间盘突出症患者诊断以及疗效评估上的作用进行分析.不仅常规肌电图在腰椎间盘突出患者的诊断、疗效评价、治疗方法的选择具有客观

  3. Efficacy Observation on Lumbar Disc Herniation with Comprehensive Therapy in 71 Cases%综合治疗腰椎间盘突出症71例疗效观察

    Institute of Scientific and Technical Information of China (English)

    周增录; 王勇; 张晓被

    2013-01-01

      目的:观察综合治疗腰椎间盘突出症的临床疗效。方法:将142例腰椎间盘突出症患者随机分为治疗组和对照组,治疗组给予牵引、推拿、骶管注射治疗,对照组给予牵引、推拿治疗。结果:治疗组总有效率95.7%,高于对照组的78.8%(P<0.05)。结论:综合治疗腰椎间盘突出症疗效确切,安全性高,值得临床应用。%Objective:To observe the clinical effects of lumbar disc herniation with comprehensive therapy. Methods:142 cases of lumbar disc hernia-tion were randomly divided into treatment group and control group, treatment group was treated with traction, massage and sacral canal injection, while the control group was given therapy of traction and massage. Results:The total effective rate of treatment group was 95.7%, higher than that of control group by 78.8%(P<0.05). Conclusion:The curative effects of comprehensive treatment on lumbar disc herniation are exact and highly safe, being worthy of clinical application.

  4. The Clinical Curative Effect of TCM Comprehensive Treatment of 78 Cases of Lumbar Disc Herniation%中医综合治疗78例腰间盘突出症临床疗效

    Institute of Scientific and Technical Information of China (English)

    赵德富

    2015-01-01

    Objective To probe into the clinical curative effect of integrated traditional Chinese medicine in the treatment of lumbar disc herniation. Methods Selected in our hospital for treatment of lumbar disc herniation in 78 patients as the research object, and give the comprehensive treatment of tcm. Results 32 cases excellent, 41 cases were effective, 5 cases ineffective, the total effective rate was 93.58%. Conclusion TCM Comprehensive Treatment of lumbar disc herniation method is simple, no side effects, less pain, short treatment period, the treatment effect is obvious, it is worth in clinical promotion.%目的:探析中医综合治疗腰间盘突出症临床疗效。方法选取我院就诊的腰间盘突出患者78例作为本次研究对象,并给予中医综合治疗。结果显效为32例,有效为41例,无效5例,总有效率为93.58%。结论中医综合治疗腰间盘突出症方法简便,无副作用,痛苦小,治疗周期短,治疗效果明显。

  5. Clinical Observation of Tendon Massage Treating Lumbar Disc Herniation in 100 Cases%经筋推拿治疗腰椎间盘突出症100例临床观察

    Institute of Scientific and Technical Information of China (English)

    邓万祥

    2013-01-01

      目的:观察经筋推拿治疗腰椎间盘突出症的临床疗效。方法:对本院采用经筋推拿治疗的100例腰椎间盘突出症病人的临床疗效进行总结。结果:痊愈53例,显效34例,有效13例,总有效率100%。结论:经筋推拿对腰椎间盘突出症具有良好的临床疗效。%Objective:To observe the clinical efficacy of tendon massage treating lumbar disc herniation. Methods:The clinical efficacy of tendon massage treating Lumbar Disc Herniation in 100 cases was summarized in our hospital. Results:53 cases were cured, with 34 cases effective, 13 cas-es valid, the total efficiency was 100%. Conclusion:There is good clinical efficacy of tendon massage treating lumbar disc herniation.

  6. 推拿治疗腰椎间盘突出症的临床疗效观察%To Observe the Clinical Effect of Massage Treatment of Lumbar Disc Herniation

    Institute of Scientific and Technical Information of China (English)

    李新建

    2013-01-01

    Objective: To observe the clinical effect of massage treatment of lumbar disc herniation. Methods: 120 cases of patients with lumbar disc herniation were treated with acupuncture point massage, meridians massage, restitutional manipulation massage, which were evaluated therapeutic effect after one course of treatment. Results: 50 cases were cured, effective in 30 cases, 31 cases were improved, 9 cases ineffective, the total efficiency was 92.5%. Conclusion: Massage treatment of lumbar disc herniation is very effective, it is worthy of clinical application.%  目的:观察推拿治疗腰椎间盘突出症的临床疗效.方法:120例腰椎间盘突出症患者均予推拿穴位、推拿经筋、推拿整复手法治疗,一个疗程后评价疗效.结果:治愈50例,显效30例,好转31例,无效9例,总有效率92.5%.结论:推拿治疗腰椎间盘突出症疗效显著,值得临床应用.

  7. 定位温针灸结合电针治疗腰椎间盘突出症疗效观察%Efficacy Observation on Positioning Needle-warming Moxibustion Combined with Electro-acupuncture Treating Disc Herniation Lumbar

    Institute of Scientific and Technical Information of China (English)

    吴晓兰

    2013-01-01

    目的:观察定位温针灸和电针治疗腰椎间盘突出症的疗效。方法:118例门诊腰椎间盘突出症患者采用定位温针灸及电针治疗,3个疗程后评定效果。结果:治愈56例,好转58例,无效4例,总有效率为96.6%。结论:定位温针灸结合电针治疗腰椎间盘突出症安全有效。%Objective:To observe the curative effects of positioning needle-warming moxibustion and electro-acupuncture treating lumbar disc hernia-tion. Methods:118 cases of clinical patients with lumbar disc herniation were treated with positioning needle-warming moxibustion and electro-acu-puncture, to assess the effects after three courses. Results:56 cases were cured, 58 cases improved, 4 cases ineffective, and the total effective rate was 96.6%. Conclusion:Positioning needle-warming moxibustion and electro-acupuncture treating lumbar disc herniation is safe and effective.

  8. 综合疗法治疗腰椎间盘突出症76例体会%Experience for treating 76 cases of lumbar disc herniation by the comprehensive therapy

    Institute of Scientific and Technical Information of China (English)

    谭秋翔

    2014-01-01

    目的:观察综合疗法治疗腰椎间盘突出症的临床疗效。方法:对76例腰椎间盘突出症采用综合疗法治疗,10d为1个疗程。结果:76例患者中,62例完全治愈,12例好转,2例无效。结论:综合疗法治疗腰椎间盘突出症疗效确切。%Objective:To observe clinical effects of comprehensive therapy on lumbar disc herniation. Methods:76 patients with lumbar disc herniation were treated by comprehensive therapy, 10d for 1 course. Results: In 76 patients, 62 were completely cured, 12 patients were improved, and 2 patients were invalid. Conclusion:The comprehensive therapy on lumbar disc herniation was confirmed with good clinical effects.

  9. 综合疗法治疗腰椎间盘突出症的疗效观察%Observation of curative effect by comprehensive therapy for lumbar disc herniation

    Institute of Scientific and Technical Information of China (English)

    黄先寿; 黄莉蓉

    2016-01-01

    目的:观察电针、推拿配合药透治疗腰椎间盘突出症的疗效。方法420例腰椎间盘突出症患者,采用电针、推拿配合药透治疗,观察疗效。结果420例患者治愈312例(74.3%)、好转106例(25.2%)、未愈2例(0.5%),总有效率为99.5%。结论电针、推拿配合药透治疗腰椎间盘突出症疗效满意。%Objective To observe curative effect by electroacupuncture, manipulation combined with Chinese medicine infiltration in the treatment of lumbar disc herniation.Methods A total of 420 lumbar disc herniation patients received electroacupuncture, manipulation combined with Chinese medicine infiltration for treatment, and their curative effects were observed.Results Among 420 patients, there were 312 cured cases (74.3%), 106 improved cases (25.2%) and 2 unhealed cases (0.5%), with total effective rate as 99.5%.Conclusion Combination of electroacupuncture, manipulation and Chinese medicine infiltration provides satisfactory curative effect in treating lumbar disc herniation.

  10. 血瘀型腰椎间盘突出症的治疗方法研究%Study on the Treatment of Blood Stasis Type of Lumbar Disc Herniation

    Institute of Scientific and Technical Information of China (English)

    杨爱国; 高建成; 王东

    2014-01-01

    腰椎间盘突出症是临床常见病、高发病,而血瘀型是其中的一个重要分型。对于血瘀型腰椎间盘突出症的治疗,目前已有口服汤剂、针灸、推拿等多种方法,本文将着重对各种治疗方法在血瘀型腰椎间盘突出症治疗中的应用作一综述。%Lumbar disc herniation is a kind of clinical common disease as well as high incidence, while blood stasis type is one of the most important types. There are various treatment for blood stasis type of lumbar disc herniation, such as oral decoction, acupuncture, massage and the like, this pa-per focuses on summarizing the application of various treatment for blood stasis type of lumbar disc herniation.

  11. 推拿配合人工牵拉闪压腰法及针刺治疗腰椎间盘突出症%Massage Combined with Artificial Traction Flash Press Waist Method and Acupuncture Treating Lumbar Disc Herniation

    Institute of Scientific and Technical Information of China (English)

    黄利云; 张胜良; 靳伟跃; 杨粉霞; 张志文

    2013-01-01

    目的:探讨中医治疗腰椎间盘突出症的创新方法。方法:152例腰椎间盘突出症患者应用推拿手法及人工牵拉瞬间闪压相应椎旁痛点,并配合针刺治疗。结果:治愈81例,显效35例,好转25例,无效11例,总有效率为92.76%。结论:推拿配合人工牵拉闪压腰法及针刺治疗腰椎盘突出症安全有效,无毒副作用,患者易于接受。%Objective:To explore the innovative methods of traditional Chinese medicine treating lumbar disc herniation. Methods:152 cases of lum-bar disc herniation were applied with massage combined with artificial traction flash pressing corresponding paravertebral point of pain and acupunc-ture. Results:81 cases were cured, 35 cases markedly effective, 25 cases improved, 11 cases ineffective, the total effective rate was 92.76%. Conclu-sion:Massage combined with artificial traction flash press waist method and acupuncture treating lumbar disc herniation is safe and effective, with-out toxic and side effects, easily accepted by patients.

  12. Efficacy Observation on Massage for 99 Cases of Lumbar Disc Herniation Patients%推拿治疗腰椎间盘突出症99例疗效观察

    Institute of Scientific and Technical Information of China (English)

    尹旭

    2013-01-01

    Objective:To observe the efficacy of massage for lumbar disc herniation. Methods:99 cases of lumbar disc herniation patients were all treated by massage therapy. Results:58 cases were cured, 48 cases turned better, 3 cases invilid, the total effective rate was 96.97%. Conclusion:Use massage therapy to treat lumbar disc herniation is safe, less pain, no complication, and it has good efficacy, quickly becomes effective, and good pa-tient compliance.%目的:观察推拿治疗腰椎间盘突出症的疗效。方法:对99例腰椎间盘突出症患者均给予推拿治疗。结果:痊愈58例,好转48例,未愈3例,总有效率为96.97%。结论:采用推拿治疗腰椎间盘突出症安全、痛苦小、无并发症,且疗效高、见效快、患者依从性好。

  13. 牵引、推拿治疗腰椎间盘突出症48例疗效观察%Efficacy Observation on Traction and Massage Therapy for Lumbar Disc Herniation

    Institute of Scientific and Technical Information of China (English)

    陈斯亮

    2013-01-01

    目的:观察牵引、推拿治疗腰椎间盘突出症的疗效。方法:对48例腰椎间盘突出症患者均采用牵引和推拿手法治疗。结果:治愈32例,显效8例,有效6例,无效2例,总有效率为95.8%。结论:牵引、推拿治疗腰椎间盘突出症疗效优良,值得临床推广应用。%Objective:To observe the efficacy of treating lumbar disc herniation by traction and massage. Methods:48 cases of lumbar disc herniation patients were all treated by traction and massage therapy. Results:32 cases were cured, 8 cases had marked effect, 6 cases were effective, 2 cases in-valid, the total effective rate was 95.8%. Conclusion:Traction and massage have a good curative effect on lumbar disc herniation, deserves clinical promotion and application.

  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. Comparison of Therapeutic Effects Between Acupuncture plus Sacral Injection and Simple Acupuncture for Lumbar Intervertebral Disc Herniation

    Institute of Scientific and Technical Information of China (English)

    YAN Jie-ying; XU Yao

    2007-01-01

    To compare the therapeutic effects between acupuncture plus sacral injection and simple acupuncture for intervertebral disc hemia.Methods:The patients with lumbar intervertebral disc hernia at the age of 30-45 years old were divided into No.1-80 upon their visiting order,with odd number as Group A and even number as Group B.Group A was treated by acupuncture plus sacral injection,and Group B was treated by simple acupuncture.Results:The clinical effective rate was higher in Group A than in Group B,with significant difference (P<0.05).Conclusion:Acupuncture plus sacral injection had the better therapeutic effect than simple acupuncture in treating lumbar intervertebral disc hernia.

  16. Scalene myofascial pain syndrome mimicking cervical disc prolapse: a report of two cases.

    Science.gov (United States)

    Abd Jalil, Nizar; Awang, Mohammad Saufi; Omar, Mahamarowi

    2010-01-01

    Scalene myofascial pain syndrome is a regional pain syndrome wherein pain originates over the neck area and radiates down to the arm. This condition may present as primary or secondary to underlying cervical pathology. Although scalene myofascial pain syndrome is a well known medical entity, it is often misdiagnosed as being some other neck pain associated with radiculopathy, such as cervical disc prolapse, cervical spinal stenosis and thoracic outlet syndrome. Because scalene myofascial pain syndrome mimics cervical radiculopathy, this condition often leads to mismanagement, which can, in turn, result in persistent pain and suffering. In the worst-case scenarios, patients may be subjected to unjustifiable surgical intervention. Because the clinical findings in scalene myofascial pain syndrome are "pathognomonic", clinicians should be aware of ways to recognize this disorder and be able to differentiate it from other conditions that present with neck pain and rediculopathy. We present two cases of unilateral scalene myofascial pain syndrome that significantly impaired the patients' functioning and quality of life. This case report serves to create awareness about the existence of the syndrome and to highlight the potential morbidity due to clinical misdiagnosis.

  17. An Outcome Study of Anterior Cervical Discectomy and Fusion among Iranian Population

    Directory of Open Access Journals (Sweden)

    Ali Haghnegahdar

    2016-01-01

    Full Text Available Background and Aim. First-line treatment strategy for managing cervical disc herniation is conservative measures. In some cases, surgery is indicated either due to signs/symptoms of severe/progressive neurological deficits, or because of persistence of radicular pain despite 12 weeks of conservative treatment. Success for treatment of cervical disc herniation using ACDF has been successfully reported in the literature. We aim to determine the outcome of ACDF in treatment of cervical disc herniation among Iranians. Methods and Materials/Patients. In a retrospective cohort study, we evaluated 68 patients who had undergone ACDF for cervical disc herniation from March 2006 to March 2011. Outcome tools were as follows: (1 study-designed questionnaire that addressed residual and/or new complaints and subjective satisfaction with the operation; (2 recent (one week prior to the interview postoperative VAS for neck and upper extremity radicular pain; (3 Japanese Orthopaedic Association Myelopathy Evaluation Questionnaire (JOACMEQ (standard Persian version; and (4 follow-up cervical Magnetic Resonance Imaging (MRI and lateral X-ray. Results. With mean follow-up time of 52.93 (months ± 31.89 SD (range: 13–131 months, we had success rates with regard to ΔVAS for neck and radicular pain of 88.2% and 89.7%, respectively. Except QOL functional score of JOAMEQ, 100% success rate for the other 4 functional scores of JOAMEQ was achieved. Conclusion. ACDF is a successful surgical technique for the management of cervical disc herniation among Iranian population.

  18. 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.

  19. 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.

  20. An investigation on the treatment of intraprotrusion or intradisk injection with couagenase for lumber disc herniation%在椎间盘突出物或椎间盘内注射胶原酶对椎间盘突出症治疗作用的研究

    Institute of Scientific and Technical Information of China (English)

    虞乐华; 吴南顺; 张宽平

    2002-01-01

    Objective To compare effect of chemonucleolysis of collagenase injected intraprotrusion(disc protrusion) with intradisk (disc centre ) at the affected disc guided by computer scan(CT) on lumbar disc herniation. Method 156 patients were randomly divided into two groups.Repeat CT shows guided 1200 U collagenase intraprotrusion or intradisk injection of the affected disc via extradural or intradual way for the patients.3 month follow up was performed to evaluate the therapeutic effect.Result The observation indicated that the patients showed no any seriously side effect.The effective rate was 86% for intraprotrusion injection and 71% for intradisk injection respectively.χ 2 test demonstrated the difference was significant(χ 2=5.3969).Conclusion Guided under CT, intraprotrusion injection with collagenase at the affected disc is safe,more effective treatment than that of intradisk injections for lumbar disc herniation.

  1. Study of the influence of degenerative intervertebral disc changes on the deformation behavior of the cervical spine segment in flexion

    Science.gov (United States)

    Kolmakova, Tatyana V.

    2016-11-01

    The paper describes the model of the cervical spine segment (C3-C4) and the calculation results of the deformation behavior of the segment under degenerative changes of the intervertebral disc. The segment model was built based on the experimental literature data taking into account the presence of the cortical and cancellous bone tissue of vertebral bodies. The calculation results show that degenerative changes of the intervertebral disc cause the immobility of the C3 vertebra at flexion.

  2. Motion analysis of total cervical disc replacements using computed tomography: Preliminary experience with nine patients and a model

    Energy Technology Data Exchange (ETDEWEB)

    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 deviations of the mean using the 95% limits of agreement with no overlapping confidence intervals. The accuracy analysis showed that the median error was close to zero. Conclusion. The mobility of the cervical spine after total disc replacement can be effectively measured in vivo using CT. This method requires an appropriate patient positioning and scan parameters to achieve suitable image quality

  3. Prolonged conservative treatment or 'early' surgery in sciatica caused by a lumbar disc herniation: rationale and design of a randomized trial [ISRCT 26872154

    Directory of Open Access Journals (Sweden)

    Tans Joseph

    2005-02-01

    Full Text Available Abstract Background The design of a randomized multicenter trial is presented on the effectiveness of a prolonged conservative treatment strategy compared with surgery in patients with persisting intense sciatica (lumbosacral radicular syndrome. Methods/design Patients presenting themselves to their general practitioner with disabling sciatica lasting less than twelve weeks are referred to the neurology outpatient department of one of the participating hospitals. After confirmation of the diagnosis and surgical indication MRI scanning is performed. If a distinct disc herniation is discerned which in addition covers the clinically expected site the patient is eligible for randomization. Depending on the outcome of the randomization scheme the patient will either be submitted to prolonged conservative care or surgery. Surgery will be carried out according to the guidelines and between six and twelve weeks after onset of complaints. The experimental therapy consists of a prolonged conservative treatment under supervision of the general practitioner, which may be followed by surgical intervention in case of persisting or progressive disability. The main primary outcome measure is the disease specific disability of daily functioning. Other primary outcome measures are perceived recovery and intensity of legpain. Secondary outcome measures encompass severity of complaints, quality of life, medical consumption, absenteeism, costs and preference. The main research question will be answered at 12 months after randomization. The total follow-up period covers two years. Discussion Evidence is lacking concerning the optimal treatment of lumbar disc induced sciatica. This pragmatic randomized trial, focusses on the 'timing' of intervention, and will contribute to the decision of the general practictioner and neurologist, regarding referral of patients for surgery.

  4. Inhibition of cystathionine β-synthetase suppresses sodium channel activities of dorsal root ganglion neurons of rats with lumbar disc herniation

    Science.gov (United States)

    Yan, Jun; Hu, Shufen; Zou, Kang; Xu, Min; Wang, Qianliang; Miao, Xiuhua; Yu, Shan Ping; Xu, Guang-Yin

    2016-01-01

    The pathogenesis of pain in lumbar disc herniation (LDH) remains poorly understood. We have recently demonstrated that voltage-gated sodium channels (VGSCs) in dorsal root ganglion (DRG) neurons were sensitized in a rat model of LDH. However, the detailed molecular mechanism for sensitization of VGSCs remains largely unknown. This study was designed to examine roles of the endogenous hydrogen sulfide synthesizing enzyme cystathionine β-synthetase (CBS) in sensitization of VGSCs in a previously validated rat model of LDH. Here we showed that inhibition of CBS activity by O-(Carboxymethyl) hydroxylamine hemihydrochloride (AOAA) significantly attenuated pain hypersensitivity in LDH rats. Administration of AOAA also reduced neuronal hyperexcitability, suppressed the sodium current density, and right-shifted the V1/2 of the inactivation curve, of hindpaw innervating DRG neurons, which is retrogradely labeled by DiI. In vitro incubation of AOAA did not alter the excitability of acutely isolated DRG neurons. Furthermore, CBS was colocalized with NaV1.7 and NaV1.8 in hindpaw-innervating DRG neurons. Treatment of AOAA markedly suppressed expression of NaV1.7 and NaV1.8 in DRGs of LDH rats. These data suggest that targeting the CBS-H2S signaling at the DRG level might represent a novel therapeutic strategy for chronic pain relief in patients with LDH. PMID:27905525

  5. Collagenase chemonucleolvsis for treatment of 1600 patients with lumbar disc herniation%胶原酶溶解术治疗腰椎间盘突出症1600例

    Institute of Scientific and Technical Information of China (English)

    王义清; 王执民; 张洪新; 郭卫平; 关彦; 李文献

    2001-01-01

    目的 通过1600例临床观察,总结分析胶原酶化学溶解术治疗腰椎间盘突出症的临床应用价值. 方法 1994-10/1999-10采用硬膜外注射,部分采用盘内注射胶原酶300 U治疗腰椎间盘突出症1600例. 结果 1200例患者术后3~48 mo随访,总有效率96.67%,优良率90.58%. 结论 硬膜外注射胶原酶治疗腰椎间盘突出症,安全、创伤小、疗效满意.%AIM To analyse the clinical effect of chemonucleolvsis with the collagenase for the treatment of lumbar disc herniation. METHODS Collagenase was injected into the lumbar disc 300 U or outside the lumbar dise mostly for the treatment of lumbar disc herniation from octember 1994 to octember 1999. RESULTS 1200 cases were followed up after the operation from 3 to 48 months. The results were effective in 96.67% and excellent or good in 90.58%. CONCLUSION Chemonucleolvsis with the collagenase outside the lumbar disc is safe and effective.

  6. The significance of determination of Matrix Metalloproteinase-3(MMP-3)content in lumbar disc herniation.%腰椎间盘突出症血清MMP-3测定的意义

    Institute of Scientific and Technical Information of China (English)

    郑昱新; 石印玉

    2001-01-01

    Objective To investigate the relationship between sero-matrix mefalloproteinase-3(MMP-3) content and lumbar disc herniation.Method The sero-MMP-3 content in 32 patients with lumbar disc herniation and 10 normal human were determined with enzyme-immunoassay method.Result The mean sero-MMP-3 content in lumbar disc herniation was 35.57ng/ml,while normal human27.56ng/ml,the deference was siginificant (P<0.01).However the sero-MMP-3 content in lumbar disc prolapsus was siginificantly higher than that in nonprolapsus(P<0.05).Conclusion The determination of sero-MMP-3 content can be used as assistant diagnosis of the lumbar disc herniation,furthermore confirm the relationship between sero-MMP-3 content and degree of lumbar disc degeneration.%目的 进一步研究血清MMP-3的含量与腰椎间盘突出症发病的关系。方法 32例腰椎间盘突出症患者和10例正常人,用酶免疫法测定他们血清MMP-3的含量。结果 腰椎间盘突出症患者血清MMP-3含量的平均值为:35.57ng/ml,而正常人平均值为:27.56ng/ml,两者的差异有显著性意义(P<0.01)。其中脱出型腰椎间盘突出症患者的血清MMP-3含量明显高于非脱出型患者(P<0.05)。结论 血清MMP-3的测定可作为对腰椎间盘突出症的辅助诊断,并且证实血清MMP-3的含量与腰椎间盘的退变程度相关。

  7. 颈椎间盘置换及前路椎间融合治疗单节段颈椎间盘突出症:谁更多影响邻近节段发生退变?%Anterior cervical disc replacement and anterior cervical decompression and fusion for treating single segment cervical disc herniation:which has greater effects on adjacent segment degeneration?

    Institute of Scientific and Technical Information of China (English)

    刘威; 盛伟斌; 张健; 邓强; 郭海龙

    2016-01-01

    背景:有研究表明,颈椎间盘置换及前路固定融合治疗颈椎病可以取得较好的临床效果,但是哪种术式在避免邻近节段退变方面更具优势尚无定论。目的:比较颈椎间盘置换与前路固定融合治疗单节段颈椎间盘突出症对邻近节段的近期影响。方法:收集2009年1月至2012年12月以“颈椎间盘突出症”为诊断收入院并行单节段颈椎间盘置换或颈前路椎间盘切除融合患者178例的临床资料,进行回顾性分析,其中前路固定融合组116例,颈椎间盘置换组62例。结果与结论:①评价:两组患者末次随访时目测类比评分、日本骨科协会评估治疗评分、颈椎功能障碍指数均较治疗前明显改善(P 0.05)。前路固定融合组术后3个月时手术节段基本融合,活动度丧失,末次随访时邻近上位节段活动度与邻近下位节段活动度明显增加,且上位节段活动度增加的度数较下位节段大(P 0.05). At 3 months after surgery, in the anterior cervical decompression and fusion group, surgical segment was confluent, and range of motion lost. During final fol ow-up, range of motion of adjacent upper segment and adjacent lower segment was significantly increased, and the increased range of motion in the upper segment was bigger than that of the lower segment (P < 0.05). (3) During final fol ow-up, X-ray films and MRI images revealed the number of degenerated adjacent segment was more in the anterior cervical decompression and fusion group than in the anterior cervical disc replacement group (P <0.05). The number of degenerated middle and upper segments was more than that of the lower segment in both groups (P < 0.05). (4) The findings confirmed that anterior cervical disc replacement or anterior cervical decompression and fusion for treating cervical disc herniation could effectively relieve nerve symptoms of patients. However, compared with the anterior cervical disc

  8. The incidence of adjacent segment degeneration after cervical disc arthroplasty (CDA: a meta analysis of randomized controlled trials.

    Directory of Open Access Journals (Sweden)

    Baohui Yang

    Full Text Available BACKGROUND: Cervical disc arthroplasty is being used as an alternative degenerative disc disease treatment with fusion of the cervical spine in order to preserve motion. However, whether replacement arthoplasty in the spine achieves its primary patient centered objective of lowering the frequency of adjacent segment degeneration is not verified yet. METHODOLOGY: We conducted a meta-analysis according to the guidelines of the Cochrane Collaboration using databases including PubMed, Cochrane Central Register of Controlled Trials and Embase. The inclusion criteria were: 1 Randomized, controlled study of degenerative disc disease of the cervical spine involving single segment or double segments using Cervical disc arthroplasty (CDA with anterior cervical discectomy and fusion (ACDF as controls; 2 A minimum of two-year follow-up using imaging and clinical analyses; 3 Definite diagnostic evidences for "adjacent segment degeneration" and "adjacent segment disease"; 4 At least a minimum of 30 patients per population. Two authors independently selected trials; assessed methodological quality, extracted data and the results were pooled. RESULTS: No study has specifically compared the results of adjacent segment degenerative; Two papers describing 140 patients with 162 symptomatic cervical segment disorders and compared the rate of postoperative adjacent segment disease development between CDA and ACDF treatments, three publications describing the rate of adjacent-segment surgery including 1273 patients with symptomatic cervical segments. The result of the meta-analysis indicates that there were fewer the rate of adjacent segment disease and the rate for adjacent-segment surgery comparing CDA with ACDF, but the difference was not statistically significant. CONCLUSIONS: Based on available evidence, it cannot be concluded, that CDA can significantly reduce the postoperative rate of the adjacent segment degenerative and adjacent segment disease. However, due

  9. Imaging techniques for diagnosis after surgery for degenerative disc disease. Bildgebende Diagnostik nach spinaler Diskushernienoperation

    Energy Technology Data Exchange (ETDEWEB)

    Trattnig, S. (Abt. fuer Osteologie, MR-Inst., Universitaetsklinik fuer Radiodiagnostik, Vienna (Austria)); Kramer, J. (Abt. fuer Osteologie, MR-Inst., Universitaetsklinik fuer Radiodiagnostik, Vienna (Austria)); Muehlbauer, M. (Neurochirurgische Univ.-Klinik, Vienna (Austria)); Kainberger, F. (Abt. fuer Osteologie, MR-Inst., Universitaetsklinik fuer Radiodiagnostik, Vienna (Austria)); Imhof, H. (Abt. fuer Osteologie, MR-Inst., Universitaetsklinik fuer Radiodiagnostik, Vienna (Austria))

    1993-10-01

    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.)

  10. Biochemical imaging of cervical intervertebral discs with glycosaminoglycan chemical exchange saturation transfer magnetic resonance imaging: feasibility and initial results

    Energy Technology Data Exchange (ETDEWEB)

    Schleich, Christoph; Mueller-Lutz, Anja; Zimmermann, Lisa; Boos, Johannes; Wittsack, Hans-Joerg; Antoch, Gerald; Miese, Falk [Department of Diagnostic and Interventional Radiology, University Dusseldorf, Medical Faculty, Dusseldorf (Germany); Schmitt, Benjamin [Siemens Ltd. Australia, Healthcare Sector, Macquarie Park, NSW (Australia)

    2016-01-15

    To evaluate glycosaminoglycan chemical exchange saturation transfer (gagCEST) imaging at 3T in the assessment of the GAG content of cervical IVDs in healthy volunteers. Forty-two cervical intervertebral discs of seven healthy volunteers (four females, three males; mean age: 21.4 ± 1.4 years; range: 19-24 years) were examined at a 3T MRI scanner in this prospective study. The MRI protocol comprised standard morphological, sagittal T2 weighted (T2w) images to assess the magnetic resonance imaging (MRI) based grading system for cervical intervertebral disc degeneration (IVD) and biochemical imaging with gagCEST to calculate a region-of-interest analysis of nucleus pulposus (NP) and annulus fibrosus (AF). GagCEST of cervical IVDs was technically successful at 3T with significant higher gagCEST values in NP compared to AF (1.17 % ± 1.03 % vs. 0.79 % ± 1.75 %; p = 0.005). We found topological differences of gagCEST values of the cervical spine with significant higher gagCEST effects in lower IVDs (r = 1; p = 0). We could demonstrate a significant, negative correlation between gagCEST values and cervical disc degeneration of NP (r = -0.360; p = 0.019). Non-degenerated IVDs had significantly higher gagCEST effects compared to degenerated IVDs in NP (1.76 % ± 0.92 % vs. 0.52 % ± 1.17 %; p < 0.001). Biochemical imaging of cervical IVDs is feasible at 3T. GagCEST analysis demonstrated a topological GAG distribution of the cervical spine. The depletion of GAG in the NP with increasing level of morphological degeneration can be assessed using gagCEST imaging. (orig.)

  11. EVALUATION OF TERMINAL VERTEBRAL PLATE ON CERVICAL SPINE AT DIFFERENT AGE GROUPS AND ITS CORRELATION WITH INTERVERTEBRAL DISC THICKNESS

    Science.gov (United States)

    Luiz Vieira, Juliano Silveira; da Silva Herrero, Carlos Fernando Pereira; Porto, Maximiliano Aguiar; Nogueira Barbosa, Marcello Henrique; Garcia, Sérgio Britto; Zambelli Ramalho, Leandra Náira; Aparecido Defino, Helton Luiz

    2015-01-01

    To evaluate, by means of histomorphometry, terminal vertebral plate thickness, intervertebral disc thickness and its correlation on different age groups, seeking to identify its correlation. Methods: C4-C5 and C5-C6 cervical segments removed from human cadavers of both genders were assessed and divided into five groups of 10-year age intervals, from 21 years old. TVP and intervertebral disc thickness evaluation was made by means of histomorphometry of histological slides stained with hematoxylin and eosyn. Lower C4 TVP, upper C5 TVP, and upper C6 TVP de were compared between each other and to the interposed intervertebral disc thickness between relevant TVP. Results: The thickness of terminal vertebral plates adjacent to the same ID did not show statistic differences. However, the comparison of upper and lower vertebral plates thickness on the same cervical vertebra (C5), showed statistical difference on all age groups studied. We found a statistical correlation coefficient above 80% between terminal vertebral plate and adjacent intervertebral disc, with a proportional thickness reduction of both structures on the different cervical levels studied, and also on the different age groups assessed. Conclusion: Terminal vertebral plate shows a morphologic correlation with the intervertebral disc next to it, and does not show correlation with the terminal vertebral plate on the same vertebra. PMID:26998448

  12. Biomechanics of a posture-controlling cervical artificial disc: mechanical, in vitro, and finite-element analysis.

    Science.gov (United States)

    Crawford, Neil R; Arnett, Jeffery D; Butters, Joshua A; Ferrara, Lisa A; Kulkarni, Nikhil; Goel, Vijay K; Duggal, Neil

    2010-06-01

    Different methods have been described by numerous investigators for experimentally assessing the kinematics of cervical artificial discs. However, in addition to understanding how artificial discs affect range of motion, it is also clinically relevant to understand how artificial discs affect segmental posture. The purpose of this paper is to describe novel considerations and methods for experimentally assessing cervical spine postural control in the laboratory. These methods, which include mechanical testing, cadaveric testing, and computer modeling studies, are applied in comparing postural biomechanics of a novel postural control arthroplasty (PCA) device versus standard ball-and-socket (BS) and ball-in-trough (BT) arthroplasty devices. The overall body of evidence from this group of tests supports the conclusion that the PCA device does control posture to a particular lordotic position, whereas BS and BT devices move freely through their ranges of motion.

  13. The Use of Magnetic Resonance Imaging to Predict the Clinical Outcome of Non-Surgical Treatment for Lumbar Interverterbal Disc Herniation

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Soo Jung; Kim, Chung Hwan; Shin, Myung Jin; Ryu, Dae Sik; Ahn, Jae Hong; Jung, Seung Moon; Park, Man Soo [GangNeung Asan Hospital, University of Ulsan College of Medicine, GangNeung, Seoul (Korea, Republic of); Song, Jae Seok [University of Kwandong College of Medicine, GangNeung (Korea, Republic of)

    2007-04-15

    We wanted to investigate the relationship between the magnetic resonance (MR) findings and the clinical outcome after treatment with non-surgical transforaminal epidural steroid injections (ESI) for lumbar herniated intervertebral disc (HIVD) patients. Transforaminal ESI were performed in 91 patients (50 males and 41 females, age range: 13 78 yrs) because of lumbosacral HIVD from March 2001 to August 2002. Sixty eight patients whose MRIs and clinical follow-ups were available were included in this study. The medical charts were retrospectively reviewed and the patients were divided into two groups; the successful (responders, n = 41) and unsatisfactory (non-responders, n = 27) outcome groups. A successful outcome required a patient satisfaction score greater than two and a pain reduction score greater than 50%. The MR findings were retrospectively analyzed and compared between the two groups with regard to the type (protrusion, extrusion or sequestration), hydration (the T2 signal intensity), location (central, right/left central, subarticular, foraminal or extraforaminal), and size (volume) of the HIVD, the grade of nerve root compression (grade 1 abutment, 2 displacement and 3 entrapment), and an association with spinal stenosis. There was no significant difference between the responders and nonresponders in terms of the type, hydration and size of the HIVD, or an association with spinal stenosis (p > 0.05). However, the location of the HIVD and the grade of nerve root compression were different between the two groups (p < 0.05). MRI could play an important role in predicting the clinical outcome of non-surgical transforaminal ESI treatment for patients with lumbar HIVD.

  14. 老年腰椎间盘突出症的手术疗效观察%Surgical results of lumbar disc herniation in elderly patients

    Institute of Scientific and Technical Information of China (English)

    马学晓; 岳斌; 相宏飞; 张国庆; 胡有谷; 杨克石; 陈伯华

    2012-01-01

    目的 回顾性观察老年腰椎间盘突出症患者术后疗效.方法 报告1994年7月至2011年11月因腰椎间盘突出症在我院手术治疗的患者共95例,年龄60~85(平均70.3)岁,男59例,女36例,随访时间3个月~10年(平均35.7个月).采用中华医学会骨科学分会脊柱外科学组腰背痛手术评定标准和日本骨科学会评分标准,比较不同手术方式(单纯椎间盘切除和椎间盘切除并内固定融合)、不同减压方式(开窗、半椎板切除和全椎板切除)和不同随访时间(3年以内,3~5年,5年以上)的疗效.结果 95例患者总优良率为84.2%,单纯椎间盘切除组和椎间盘切除并内固定融合组优良率分别为80.5%,87.0%,两组差异无统计学意义(P=0.694);改善率分别为(60.89±32.62)%,( 65.74±26.32)%,两组改善率差异无统计学意义(P=0.636).开窗组、半椎板切除组和全椎板切除组优良率分别为80.6%,91.3%和85.4%,3组间差异无统计学(P=0.958),3组改善率分别为(59.84±29.84)%,(62.30±27.10)%和( 62.94±31.96)%,3组间差异无统计学(P=0.835).随访时间3年以内组,3~5年组,5年以上组,其优良率分别为90.6%,77.8%和79.2%,3组间优良率差异无统计学(P=0.660);3组术后改善率分别为(62.01±25.97)%,( 55.06±35.89)%,(60.83±33.73)%,3组间差异无统计学意义(P=0.811).结论 单纯椎间盘切除与椎间盘切除并内固定融合治疗老年腰椎间盘突出症随访可获得良好疗效,开窗组、半椎板切除和全椎板切除均可获得良好疗效,且其疗效随着随访时间延长无明显变化.%Objective To investigate retrospectively the effects of surgical treatment for elderly patients with lumbar disc herniation. Methods A follow-up was conducted in patients who underwent surgery for lumbar disc herniation from July 1994 to November 2011 in our hospital. Ninty-five cases, (59 male and 36 female), aged from 60 to 85 with the average age of 70.3, were

  15. Surgery cooperation in GSS treatment of lumbar disc herniation%GSS内固定系统治疗腰椎间盘突出症的配合

    Institute of Scientific and Technical Information of China (English)

    王文芳

    2012-01-01

    目的 分析总结40例GSS内固定系统治疗腰椎间盘突出症的手术配合技术及体会.方法 术前做好各种准备工作,熟悉各种仪器、器械的使用,术中医护配合良好.结果 40例均在G臂透视机下顺利完成手术.结论 完整的术前准备、熟练掌握整个手术步骤,采取有效的体位和安全保护措施,术中主动、准确有序的术中配合及细致的病情观察和护理是手术成功的重要保证.%Objective To analyze and summarize the surgery cooperation technical evidence and experience in 40 cases of GSS treatment of lumbar disc herniation.Methods Various preparations were made,get familiar with the various instruments,keep the good surgery cooperation in progress.Results With the help of G-arm,all 40 cases completed the operation successfully.Conclusions The intact preoperative preparation,good command of the entire operation steps,taking effective postures and security protection measures,the activated,precise and orderly cooperation,complex and delicate condition observation and care are all the important key points of a successful operation.

  16. Curative effect observation of acupuncture combined with massage in the treatment of lumbar disc herniation%针灸配合推拿治疗腰椎间盘突出症的疗效观察

    Institute of Scientific and Technical Information of China (English)

    马会军; 张同欣

    2015-01-01

    目的:观察针灸配合推拿治疗腰椎间盘突出症的疗效。方法:收治腰椎间盘突出症患者75例,采用针灸配合推拿治疗,观察其疗效。结果:75例患者中,治愈46例,好转25例,无效4例,总有效率94.67%。结论:针灸配合推拿治疗腰椎间盘突出症疗效显著。%Objective:To observe the curative effect of acupuncture combined with massage in the treatment of lumbar disc herni-ation.Methods:75 patients with lumbar disc herniation were selected.They were given acupuncture combined with massage treat-ment.Results:In 75 patients,46 cases were cured,25 cases were improved,4 cases were invalid,the total effective rate was 94.67%. Conclusion:Acupuncture combined with massage in the treatment of lumbar disc herniation have a significant curative effect.

  17. Research progress of chiropractic manipulation treatment for lumbar disc herniation%整脊手法治疗腰椎间盘突出症的研究进展

    Institute of Scientific and Technical Information of China (English)

    赵志恒; 张仁倩; 王剑歌; 王雷; 祝贺旗

    2015-01-01

    Chiropractic treatment of lumbar disc herniation is a common practice. Chiropractic operation method of the clinical applica-tion and effect is different. To further explore the clinical application of chiropractic treatment of lumbar disc herniation, in this article we reviewed the development of chiropractic therapy and clinical application of chiropractic technique on lumbar intervertebral disc protru-sion, and new insights were put forward.%整脊是治疗腰椎间盘突出症的常用手法,临床上应用的整脊操作方法各不相同,疗效也各有差异,为了进一步探究整脊治疗腰椎间盘突出症的临床应用。从整脊疗法的发展及整脊技术对腰椎间盘突出症的临床应用等方面进行了评述,对整脊的临床应用进展进行了综述,并提出新的见解。

  18. Comparison between two types of"Scheuermann disease-like people": thoracolumbar disc herniation patients and healthy volunteers with radiological signs of Scheuermann's disease

    Institute of Scientific and Technical Information of China (English)

    Guo Xinhu; Chen Zhongqiang; Liu Ning; Guo Zhaoqing; Qi Qiang; Li Weishi; Zeng Yan

    2014-01-01

    Background Scheuermann's disease (SD) is a spinal disorder and includes both a classic form and an atypical form.Interestingly,its existence among the general population as well as the disc disease patients is common.One of our previous studies showed that about 18% of the hospital staff members meet the SD criteria.On the other hand,another study has demonstrated that 95.2% of the symptomatic thoracolumbar disc herniation (STLDH) patients meet the SD criteria,which suggests that STLDH is very likely a special form of SD.The purpose of this study was to discriminate the factors contributing to the development of STLDH by comparing STLDH patients with the healthy SD-like hospital staff members.Methods This is a retrospective study including 33 STLDH patients who met the SD criteria and 30 SD-like hospital staff members.The STLDH group was chosen from a group of patients who underwent surgery after a diagnosis of STLDH (T10/11-L1/2) at our hospital between June 2007 and June 2010.SD-like hospital staff members were chosen from a database created in 2007,which contained a lumbar MR and low back pain (LBP) questionnaire of 188 hospital staff members.The demographic and radiologic characteristics were compared between groups.Results There was no statistical difference in sex,age,and height between the two groups.The STLDH patients had higher body weight,boby mass index,and thoracolumbar kyphotic angle than SD-like hospital staff members.In addition,STLDH patients had more levels of Schmorl's nodes (3.5±1.7 vs.2.0±1.9,t=3.364,P=0.001) and irregular endplateson (4.0±1.9 vs.2.7±1.9,t=2.667,P=0.010) compared to the SD-like hospital staff members.Conclusions Higher body weight,higher body mass index,larger thoracolumbar kyphosis,and more Schmorl's nodes and irregular endplates on MR may be associated with the development of STLDH in "SD-like people."

  19. 腰椎间盘突出症患者不遵医行为的调查及对策%Investigations and Countermeasures of Lumbar Disc Herniation of Patients not Following the Medical Behaviors

    Institute of Scientific and Technical Information of China (English)

    吴燕文; 卓雅淑; 张海玲

    2014-01-01

    Objective To observe the clinical characteristics of the medical incompliance behaviors of the patients with lumbar disc hernia-tion and to discuss the Improvement of the countermeasures of the medical compliance behaviors.Method Using the medical compliance be-haviors questionnaire complete a survey of 90 cases of the medical compliance behaviors of lumbar disc herniation patients,and analyze the influence factors of the medical compliance behaviors.Results Only 44.4% patients have the medical compliance behaviors,while 55.5%patients have few the medical compliance behaviors.The difference is statistically significant (P<0.01 or P<0.05 ).Conclusion Impro-ving the medical compliance behaviors plays a significant role in treatment of patients with lumbar disc herniation.%目的:观察腰椎间盘突出症不遵医行为的临床特点,探讨提高遵医行为的对策。方法采用遵医行为调查表,对90例腰椎间盘突出症患者遵医行为进行调查。结果90例患者中,遵医治疗行为只有44.4%,不完全遵医行为23.3%,完全不遵医行为32.2%,P<0.01或P<0.05。结论提高患者遵医行为对治疗腰椎间盘突出症具有重要意义。

  20. 经皮椎间孔镜治疗腰椎间盘突出症的临床观察%Clinical observation of percutaneous transforaminal endoscopic discectomy in the treatment of lumbar disc herniation

    Institute of Scientific and Technical Information of China (English)

    张军

    2015-01-01

    Objective:To observe the clinical curative effect of percutaneous transforaminal endoscopic discectomy in the treatment of lumbar disc herniation.Methods:28 patients with lumbar disc herniation were selected.They were given percutaneous transforaminal endoscopic discectomy operative treatment.The preoperative and postoperative visual analogue scales were compared.Results:The postoperative VAS score was much better than preoperative score.Conclusion:The percutaneous transforaminal endoscopic discectomy technology is better than traditional surgery on the intraoperative bleeding and recovery time.It has small destruction on spinal stability and small operation wound.It is currently more advanced minimally invasive treatment technique in the treatment of lumbar disc herniation.%目的:观察椎间孔镜治疗腰椎间盘突出症的临床疗效。方法:收治腰椎间盘突出症患者28例,给予经皮椎间孔镜手术治疗,比较术前术后的视觉疼痛模拟评分。结果:术后VAS评分明显优于术前。结论:经皮腰椎间孔镜技术在术中出血、康复时间上优于传统手术,且对脊柱稳定性破坏小,手术创伤小,应是目前治疗腰椎间盘突出症较为先进的微创治疗技术。

  1. 针灸治疗腰椎间盘突出症术后遗留疼痛34例%Treating34 cases of postoperative pain of lumbar disc herniation by acupuncture

    Institute of Scientific and Technical Information of China (English)

    王锋

    2015-01-01

    Objective: To investigate clinical efifcacy of acupuncture on postoperative pain of lumbar disc herniation. Methods: 68 cases of postoperative pain of lumbar disc herniation were randomly divided into the observed group and the control group. They were given acupuncture and conventional painkillers respectively. Results: Efifciency in the observed group was better (P<0.05). Pain scores in the observed group was lower (P<0.05). Conclusion: Acupuncture on lumbar disc herniation shows deifnite effects, could abate symptom, with shorter course, and is worthy of promotion in clinic.%目的:探讨针灸治疗腰椎间盘突出症术后遗留疼痛的临床效果。方法:选取68例腰椎间盘突出症术后遗留疼痛患者,随机分为观察组和对照组,分别给予针灸治疗和常规止痛药物治疗。结果:观察组疗效明显优于对照组(P<0.05);观察组疼痛评分明显低于对照组(P<0.05)。结论:针灸治疗腰椎间盘突出症术后遗留疼痛疗效确切,有助于缓解疼痛症状,缩短疗程,值得临床应用推广。

  2. Surgical treatment of senile lumbar disc herniation complicated with lumbar spinal stenosis%老年腰椎间盘突出合并椎管狭窄症的手术治疗

    Institute of Scientific and Technical Information of China (English)

    段俊虎

    2016-01-01

    目的:探讨老年腰椎间盘突出合并椎管狭窄症的临床疗效。方法:收治老年腰椎间盘突出合并椎管狭窄症患者90例,随机分成对照组和观察组,观察组采用手术治疗,对照组采用保守治疗,比较两组的治疗效果。结果:观察组的疗效及Oswestry功能障碍指数明显优于对照组(P<0.05)。结论:手术治疗老年腰椎间盘突出合并椎管狭窄症的临床疗效显著。%Objective:To explore the effect of senile lumbar disc herniation complicated with lumbar spinal stenosis.Methods:90 elderly patients with lumbar disc herniation complicated with lumbar spinal stenosis were selected.They were randomly divided into the control group and the observation group.The observation group was treated with surgical treatment.The control group was treated with conservative treatment.We compared the treatment effect of the two groups.Results:In the observation group,the efficacy and Oswestry dysfunction index were significantly better than those of the control group(P<0.05).Conclusion:The effect of surgical treatment for senile lumbar disc herniation complicated with lumbar spinal stenosis was significant.

  3. 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

    Directory of Open Access Journals (Sweden)

    Fernando Campos Gomes Pinto

    2002-06-01

    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.Hérnia de disco intervertebral é condição rara em crianças e adolescentes. Alguns relatos isolados e algumas séries foram publicadas. Descrevemos o caso de uma paciente de 15 anos, sem antecedentes relevantes, que apresentou hérnia de disco intervertebral em dois níveis lombares (L4-L5 e L5-S1 associada a escoliose não estrutural que melhorou após a cirurgia, sem necessidade de órtese. Baseados neste caso e no que encontramos na literatura, acreditamos que escoliose associada a hérnia de disco em jovens é resultante apenas de posição antiálgica, não representando necessariamente alteração estrutural.

  4. Treatment of lumbar disc herniation with radiofrequency thermocoagution combined with ozone undergo minimally invasive%微创介入射频热凝联合臭氧治疗腰椎间盘突出症

    Institute of Scientific and Technical Information of China (English)

    李明; 陈作文; 黎村盛

    2012-01-01

    Objective To explore the dinical curative effect of radiofrequency thermocoagulation combined with ozone undergo minimally invasive treat lumbar disc herniation. Methods 72 pationts with lumbar disc herniation underment radiofrequency thermocoaguation combined with ozone therapy,and had an analys is that was made with MacNab standard. Results All patients were treated with this method snccessfully, no-one occurred serious complication. Followed up time was from 3 moonth to 6 month after leave hospital.50 patients got an excellent result, 18 good,the satisfactory rate was 94.4%. Conclusion Radiofrequency thermocoagulation combined with ozone undergo minimally invasive is a valuable and safe mebhod for lumbar disc herniation.%目的:探讨腰椎间盘突出症微创介入下射频热凝联合臭氧治疗的疗效.方法:对72例腰椎间盘突出症患者采用微创介入射频热凝联合臭氧治疗,采用MacNab标准分析评价疗效.结果:所有患者顺利完成治疗,无严重并发症发生.出院后随访3~6月,疗效优50例,良18例,总优良率94.4%.结论:微创介入射频热凝联合臭氧治疗腰椎间盘突出症疗效好,安全性高.

  5. 零角度整脊术治疗腰推间盘突出症的临床运用%Clinical application of "Zero-angle" chiropractic technique in the treatment of lumbar disc herniation

    Institute of Scientific and Technical Information of China (English)

    王雷; 王遵来

    2011-01-01

    [Objective] To observe the clinical effect of "Zero-angle" chiropractic technique in the treatment of lumbar disc herniation.[Methods] Differentiated "Zero-angle" chiropractic technique was used to treat the thoracic, lumbar spine and sacrum in 570 cases with lumbar disc herniation. [Results] The total effective rate for IA/L5 protrusion was 99%; for L5/S1 was 98%; for L4/5+L5/S1 was 98%; for IA/5 protrusion combined with merger stenosis was 96%; for L5/S1 protrusion combined with merger stenosis was 96%. [Conclusion]"Zero-angle" chiropractic technique is one of the effective methods of conservative treatment for lumbar disc herniation.%[目的]临床观察零角度整脊术治疗腰椎间盘突出症的疗效.[方法]通过胸椎、腰椎、骶椎零角度整脊术辨证施治治疗腰椎间盘突出症570例.[结果]L4/L5突出总有效率为99%; L5/S1突出总有效率98%; L4/5+L5/S1突出总有效率为98%;L4/5合并椎管狭窄总有效率为96%; L5/S1合并椎管狭窄总有效率为96%.[结论]零角度整脊术是保守治疗腰椎间盘突出症有效方法之一.

  6. Clinical curative evaluation of three small point chiropractic techniques on lumbar intervertebral disc herniation%三小定点整脊技术对腰椎间盘突出症临床疗效评价研究

    Institute of Scientific and Technical Information of China (English)

    赵志恒; 张仁倩; 王剑歌; 祝贺旗; 王雷

    2014-01-01

    [目的]三小定点整脊技术对腰椎间盘突出症的临床疗效评价。[方法]将90例患有腰椎间盘突出症的患者随机分为两组:即三小定点整脊组和夹脊穴针刺组,分别给予三小定点整脊与夹脊穴针刺治疗,观察腰痛和坐骨神经痛的改善情况。[结果]两组在疗效及症状改善程度上均有较好的表现,且三小定点整脊组优于夹脊穴针刺组。[结论]三小定点整脊技术对腰椎间盘突出症疗效肯定。%Objective To evaluate the clinical efficacy of three small fixed point chiropractic technique for lumbar intervertebral disc herniation. [Methods] The 90 patients with lumbar intervertebral disc herniation were randomly divided into two groups: three small fixed point chiropractic group and Jiaji acupuncture group. The improvement of low back pain and sciatica was observed. [Results] Both groups had a better performance in terms of efficacy and the degree of improvement of symptoms, and the three small fixed point chiropractic group was better than Jiaji acupuncture group. [Conclusion] Efficacy of three small fixed point chiropractic techniques for lumbar intervertebral disc herniation is certain.

  7. 分期疗法治疗腰椎间盘突出症110例临床疗效观察%Clinical Observation of Stage Treatment on 110 Cases of Lumbar Disc Herniation

    Institute of Scientific and Technical Information of China (English)

    李林; 詹红生; 陈博; 张明才; 高宁阳; 石印玉

    2011-01-01

    Objeetive: To observe the curative effect of stage therapy on lumbar disc herniation. Methods: The treatment was based on different stage of lumbar disc herniation. During acute inflammation stage, the treatment was mainly intravenous drip of mannitol plus single-point deep electroacupuncture therapy, while in subacute stage, massage and lumbar traction were the major treatment. In chronic adhesion stage, maximal massage under epidural anesthesia was mainly adopted. Results:Forty-three cases were clinically cured, 57 cases were improved, and 10 cases were not cured. The cure rate was 39.1%, and the total effective rate was 90. 9 %. Conclusion:Stage treatment of lumbar disc herniation has several advantages,such as high cure rate, quick effectiveness, targeted therapy, and so on, showing high clinical value.%目的:观察分期疗法治疗腰椎间盘突出症的临床疗效.方法:采用相应的期采取相应的疗法治疗腰椎闱盘突出症.急性炎症期主要采用静滴甘露和单穴电针深刺疗法;亚急性期主要采用手法和腰椎牵引;慢性黏连期主要采用硬膜外麻醉下大推拿.结果:临床治愈43例,好转57例,未愈10例,治愈率39.1%,总有效率90.9 0A.结论:分期疗法治疗腰椎间突出症治愈率高、见效快、针对性强,有较高的临床推广价值.

  8. 牵引下推拿为主治疗钙化型腰椎间盘突出症临床观察%Clinical Observation of Traction and Massage Therapy-Based in Treating Calcified Lumbar Disc Herniation

    Institute of Scientific and Technical Information of China (English)

    徐辉; 成鲁杰; 姜培林; 王春利

    2013-01-01

    目的:探讨牵引下推拿为主治疗钙化型腰椎间盘突出症的临床疗效.方法:将符合条件的32例患者,给予牵引下推拿、电针、中频电、中药热奄包、红外线等综合治疗,分别于治疗后即时与3个月随访观察疗效.结果:治疗后即时及治疗后3个月分别给予疗效评定,好转率均达到70%以上.结论:牵引下推拿为主治疗钙化型腰椎间盘突出症可以取得临床满意疗效.%Objective:To investigate the clinical effect of traction and massage therapy-based in treating calcified lumbar disc herniation.Methods:32 patients with calcified lumbar disc herniation were all treated with comprehensive treatment using gravity traction combined with massage treatment,electro-acupuncture therapy,medium frequency electrotherapy,Chinese traditional medicine foment bag,infrared therapy.The clinical effect was observed after treatment immediately and 3 months later.Results:Evaluation of therapy effect after treatment immediately and 3 months later showed that improvement rates were both more than 70%.Conclusion:Calcified lumbar disc herniation treated by traction and massage therapy-based could have satisfied clinical effect.

  9. 推拿结合牵引治疗124例腰椎间盘突出症的疗效观察%Effect Observation of Massage Cooperated with Traction in Treatment of 124 Cases of Lumbar Disc Herniation

    Institute of Scientific and Technical Information of China (English)

    杨华娟; 杨艳芳

    2013-01-01

    Objective: To discuss the efficacy of massage cooperated with traction in treating lumbar disc herniation. Methods:124 patients with lumbar disc herniation were randomly divided into treatment group and control group, each group had 62 cases. Treatment group were treated by massage cooperated with traction, control group were treated by traction. The efficacy of two groups was compared after 30 days of treatment. Results:The total effective rate was 93.5%in treat-ment group and 64.5%in control group. The comparison had significant difference (P<0.01). Con-clusion:Massage cooperated with traction in treatment of lumbar disc herniation is effective in treat-ment, and it is safe. This method is worthy of popularization and application.%  目的:探讨推拿结合牵引治疗腰椎间盘突出症的疗效.方法:将124例腰椎间盘突出症患者随机分成治疗组及对照组各62例,治疗组给予腰部手法推拿结合牵引治疗,对照组给予牵引方法治疗,治疗30d后比较两组疗效.结果:治疗组总有效率93.5%,对照组总有效率64.5%,比较有显著性差异(P<0.01).结论:推拿结合牵引治疗腰椎间盘突出症疗效显著,安全有效,值得临床推广应用.

  10. 中医针灸推拿加牵引治疗腰椎间盘突出症临床疗效观察%Chinese acupuncture and massage therapy plus traction Clinical efficacy of lumbar disc herniation

    Institute of Scientific and Technical Information of China (English)

    田焕新

    2014-01-01

    目的:针对中医针灸推拿加牵引治疗腰椎间盘突出症的临床疗效进行观察分析。方法选择我院近期所收治的腰椎间盘突出症患者60例作为研究对象,随机分为对照组30例,观察组30例。对照组牵引治疗,观察组患者同时实施中医针灸与推拿治疗。治疗为期2个月,对比两组患者临床效果。结果观察组患者临床疗效明显高于对照组,对比差异有统计学意义(P<0.05)。结论中医针灸推拿加牵引治疗腰椎间盘突出症疗效确切,有临床推广价值,值得重视。%Objective The clinical efficacy of acupuncture and massage plus traction for treatment of lumbar disc herniation were observed and analyzed. Methods Patients with lumbar disc herniation were treated in our hospital recently as 60 cases for the study were randomly divided into a control group of 30 patients in the observation group 30 cases. Results The clinical efficacy of the observation group were significantly higher,there are significant differences in contrast,statistically significant(P<0.05). Conclusion Acupuncture Massage plus traction treatment of lumbar disc herniation exact,there are clinical value,worthy of attention.

  11. Clinical observation on acupuncture and massage treatment in 60 cases of lumbar disc herniation%针灸推拿治疗腰椎间盘突出症60例临床观察

    Institute of Scientific and Technical Information of China (English)

    陈贵莲

    2015-01-01

    Objective:To explore the clinical curative effect of acupuncture and massage treatment in lumbar disc herniation. Methods:The patients with lumbar disc herniation were randomly divided into the treatment group and the control group.The control group was given merely pelvic traction treatment,while the treatment group was given pelvic traction combined with acupuncture and massage treatment.The curative effects of patients in two groups were evaluated after discharge.Results:Two groups could improve clinical symptoms,and the curative effect of the treatment group was better than that of the control group. Conclusion:The curative effect of acupuncture and massage treatment on lumbar disc herniation is significant.%目的:探讨针灸推拿治疗腰椎间盘突出症的临床疗效。方法:将腰椎间盘突出症患者随机分为治疗组和对照组,对照组采用单纯骨盆牵引治疗,治疗组采用骨盆牵引联合针灸推拿治疗,两组患者出院后进行疗效评定。结果:两组患者临床症状均改善,治疗组疗效优于对照组。结论:针灸推拿治疗腰椎间盘突出症疗效显著。

  12. Clinical Observation on Electro-acupuncture Combined with Traction and Manipulation Treating Lumbar Disc Herniation%电针配合腰椎牵引及手法治疗腰椎间盘突出症临床观察

    Institute of Scientific and Technical Information of China (English)

    孙剑

    2014-01-01

    目的:观察电针配合牵引及手法治疗腰椎间盘突出症的临床疗效。方法:60例腰椎间盘突出症患者随机分为电针组、牵引组和观察组各20例,电针组采取电针治疗,牵引组采取腰椎牵引治疗,观察组予电针配合腰椎牵引及推拿手法治疗,3周比较三组治疗效果。结果:观察组总有效率显著高于电针组及牵引组(P<0.05)。结论:电针配合腰椎牵引及手法治疗腰椎间盘突出症疗效显著,值得临床推广。%Objective:To observe the therapeutic effect of electro-acupuncture combined with traction and manipulation treating lumbar disc hernia-tion. Methods:60 cases of lumbar disc herniation were randomly divided into electro-acupuncture group, traction group and observation group with each of 20 cases, electro-acupuncture group adopted electro-acupuncture therapy, traction group with treatment of lumbar traction, observation group treated with electro-acupuncture combined with lumbar traction and massage, therapeutic effect of the three groups was compared after 3 weeks. Re-sults:The total effective rate of observation group was both significantly higher than that of electro-acupuncture group and traction group (P<0.05). Conclusion: Electro-acupuncture combined with lumbar traction and manipulation treating lumbar disc herniation is significantly effective, being worth of clinical promotion.

  13. 牵引加运动疗法治疗腰椎间盘突出症的分析%The Analysis of Curing Lumbar Intervertebral Disc Herniation by Traction and Kinesitherapy

    Institute of Scientific and Technical Information of China (English)

    姜文

    2013-01-01

    Objective To discuss the effect of curing lumbar intervertebral disc herniation by traction and kinesitherapy. Methods Clinical data of 80 cases of lumbar intervertebral disc herniation patients in Chongqing Third Military Medical University Affiliated Hospital was analyzed, which were divided into control group( traction treatment group ) of 40 cases and observation group( traction and kinesitherapy group ) of 40 cases,and the clinical effect of the two groups was observed. Results The clinical efficacy of observation group was higher than control group( u =31.56,P <0. 05 ),the difference was statistically significant. Conclusion The clinical symptoms of curing lumbar intervertebral disc herniation by traction and kinesitherapy were obviously improved with good effect,which is worth clinical promotion.%目的 探讨牵引加运动疗法治疗腰椎间盘突出症的效果.方法 分析重庆第三军医大学附属医院腰椎间盘突出症患者80例的临床资料,依据治疗方式的不同分为对照组(牵引治疗组)40例和观察组(牵引加运动疗法治疗组)40例,观察两组临床疗效情况.结果 观察组腰椎间盘突出症患者临床治疗疗效明显高于对照组(u=31.56,P<0.05),差异有统计学意义.结论 牵引加运动疗法治疗腰椎间盘突出症临床症状改善明显,疗效良好,值得推广应用.

  14. Efficacy Observation on Wrist-ankle Acupuncture Combined with Acupoint Dressing Therapy on Lumbar Disc Herniation%腕踝针配合穴位敷贴治疗腰椎间盘突出症疗效观察

    Institute of Scientific and Technical Information of China (English)

    王维明; 杨慧勤

    2014-01-01

    Objective:To observe the curative effect of wrist-ankle acupuncture and acupoint dressing therapy on lumbar disc herniation. Methods:60 cases of lumbar disc herniation were randomly divided into experimental group and control group, experimental group with wrist-ankle acupuncture combined with acupoint dressing therapy, control group was treated with electro-acupuncture, efficacy was compared between the two groups after a course of treatment. Results:The cure rate and total effective rate of experimental group were both significantly better than those of control group (P0.05). Conclusion:Efficacy of wrist-ankle acupuncture and acupoint dressing therapy on lumbar disc her-niation is significant, which improve the cure rate and degree of pain.%目的:观察腕踝针配合穴位敷贴治疗腰椎间盘突出症的疗效。方法:60例腰椎间盘突出症患者随机分为实验组与对照组,实验组采用腕踝针配合穴位敷贴治疗,对照组采用电针治疗,1疗程后比较两组效果。结果:实验组治愈率及总有效率均显著优于对照组(P0.05)。结论:腕踝针配合穴位敷贴治疗腰椎间盘突出症疗效确切,提高治愈率及疼痛改善程度。

  15. Curative effect evaluation and complication analysis of Bryan artificial cervical disc replacement%Bryan人工颈椎间盘置换术后疗效评价及并发症分析

    Institute of Scientific and Technical Information of China (English)

    蓝旭; 许建中; 刘雪梅; 葛宝丰

    2013-01-01

    To observe the curative effects and complications nf Bryan cervical disc replacement for cervical disc herniation. Methods:From Jannary 2005 to December 2008,39 patients with cervical disc herniation were treated with Bryan cervical disc replacement. There were 20 males and 19 females,with an average age of 47 years old (ranged ,35 to 59). Spinal compression symptom (20 cases) and nerve root symptom (19 eases) were main clinical symptoms. Single level disc was replaced in 35 cases and two-level replaced in 4 cases. Offset and activity of prosthesis, cervical physiological curvature, heterotopic ossification, prosthetic fusion were observed by dynamic X-ray. According to Odom's standard and JOA score, nerve function were evaluated;and depending on NDI standard,clinical symptom and daily function status were recorded. Results: All the patients were followed up from 16 to 36 months with an average of 24 months. Nerve function obviously improved and radiating pain of upper limb completely relieved. No patient with prosthetic anterior-posterior offset more than 2 mm was found. Prosthetic flexion and extention angle was(8.5±1.8)°,left and right flexion range respectively were (3.5±1.2)° and (3.3±1.5)°. Cervical physiological curvature improved obviously or recovered normally. Three cases occurred in heterotopic ossification and 2 cases occurred in prosthetic fusion. According to Odom's standard,25 cases got an excellent results,9 good,5 fair,the rate of excellent and good was 87.2%. JOA score increased from preoperative(8.26±1.32) to (15.71±1.89) at final follow-up and NDI decreased from preoperative (43.7±3.8) to (20.1±2.9) at final follow-up. Conclusion: Treatment of cervical disc herniation with Bryan cervical disc replacement can get the good curative effects,which can obtain good nerve functional recovery,cervical stability and activity. Nevertheless, the operation has typical complication such as heterotopic ossification and prosthetic fusion. Thus.it is

  16. Percutaneous target radiofrequency thermocoagulation combined with ozone ablation in treatment of lum-bar disc herniation%经皮靶点射频热凝联合臭氧消融治疗腰椎间盘突出症

    Institute of Scientific and Technical Information of China (English)

    童迅; 秦小虎; 孙凌梅; 彭文娟; 吕客; 宋一平

    2015-01-01

    Objective To study the recent efficacy of percutaneous target radiofrequency thermocoagulation combined with o-zone ablation in treatment of lumbar disc herniation.Methods 152 patients with lumbar disc herniation were treated with percutane-ous target radiofrequency thermocoagulation combined with ozone ablation from August 2012 to December 2013.The clinical efficacy was analyzed.Results All patients were followed up from 3 months to 6 months.At Macnab low back pain assessment standards, ex-cellent in 88 cases, good in 35 cases, improved in 19 cases, poor in 10 cases, the total effective rate was 93.4%.Conclusion The recent efficacy of percutaneous target radiofrequency thermocoagulation combined with ozone ablation in treatment of lumbar disc hernia-tion was satisfactory, which is a preferred method of treatment of lumbar disc herniation.%目的:分析经皮靶点射频热凝联合臭氧消融治疗腰椎间盘突出症的近期疗效。方法2012年8月-2013年12月采用经皮靶点射频热凝联合臭氧消融治疗腰椎间盘突出症152例,对其临床疗效进行分析。结果152例均获随访,时间3~6个月,按Macnab腰腿痛手术评价标准进行评定,优88例,良35例,可19例,差10例,总有效率达93.4%。结论经皮靶点射频热凝联合臭氧消融治疗腰椎间盘突出症的近期疗效满意,是一种治疗腰椎间盘突出症的较好方法。

  17. 腰椎间盘突出症手术治疗现状与进展%Staus and Progress of Surgical Treatment in Lumbar Disc Hernia-tion

    Institute of Scientific and Technical Information of China (English)

    蒋守念; 陶海南

    2013-01-01

    In recent years, the study of status and progress on the minimally invasive surgical treatment of lumbar disc herniation was done a review, to provide a theoretical basis for rational surgical in clinical.%  本研究就近年来的微创手术治疗腰椎间盘突出症的现状及进展做一综述,以期为临床工作者选择合适术式提供理论依据。

  18. Percutaneous endosopic interlaminar discetomy for lumbar disc herniation%经皮内镜椎板间入路技术治疗腰椎间盘突出症

    Institute of Scientific and Technical Information of China (English)

    李衍朋(综述); 孟纯阳(审校)

    2016-01-01

    传统的椎板间小开窗髓核摘除术是治疗腰椎间盘突出症的经典术式。近年来经皮内镜椎板间入路腰椎间盘摘除术( percutaneous endosopic interlaminar discetomy ,PEID)逐渐应用于临床并取得了较为满意的疗效,在最近5年中,得益于新材料、新技术的进步,该技术的适应症进一步扩大,成为治疗复杂腰椎间盘突出症的一项有效的微创技术。与传统开放手术相比,PEID大大降低了因手术对患者带来的创伤和并发症,是开放手术和经皮内镜椎间孔入路腰椎间盘突出摘除术的一种有效补充。在阅读大量文献的基础上,本文就PEID治疗腰椎间盘突出症的研究现状及优缺点作一概述。%The traditional interlaminal small window discectomy is a classic surgical treatment of lumbar disc herniation.Percutaneous endosopic interlaminar discetomy ( PEID) is gradually applied to the clinical and achieved satisfactory effects.In the last 5 years, owing to the development of new materials and new technology,the technology has became an effective and minimally invasive technique for the treatment of complicated lumbar disc herniation.Compared with traditional open surgery,PEID reduces the trauma and complications caused by surgery greatly,and PEID is an effective complement to open surgery and percutane-ous endoscopic lumbar disc herniation.On the basis of reading a lot of literatures,this paper summarizes the research status,advantages and disadvantages of PEID in the treatment of lumbar disc herniation.

  19. 腰椎磁共振在腰椎间盘突出症术后复发诊断中的意义%The significance of lumbar MRI in the diagnosis of recurrented lumbar disc herniation after surgery

    Institute of Scientific and Technical Information of China (English)

    田融; 孙天威; 神兴勤; 张学利; 贾宇涛; 胡炜

    2014-01-01

    Objective To retrospectively evaluate the clinical evaluation of preoperative lumbar T2 sagittal MRI image in predicting the recurrent lumbar disc herniation (RLDH).Methods Between January 2009 and April 2011,28 patients were diagnosed as recurrent L4-5 disc herniation within 2.5 years after surgery,and 25 of them were included in the study as relapse group.At the same time,selected 25 patients implemented the same surgical methods in the same level as a control group randomly,they were all with good to excellent result and the follow-up time was at least 2.5 years.There was no statistical significance between the two groups in gender,age and body mass index(BMI) (P > 0.05).The lumbar MRI image of two groups of patients before surgery were collected and analyzed,with the disc degeneration grade classified.The x2 test was used to analyzed the difference of degeneration between the two groups of patients before surgery.Rank correlation analysis evaluated the correlation between disc degeneration and the period of time from the first operation to the recurrence.Results In terms of preoperative lumbar disc degeneration,there were 22 cases of low-grade disc degeneration and 3 cases of advanced disc degeneration in the relapse group and 5 cases and 20 cases respectively in the control group.there was significant difference between two groups (x2 =23.27,P < 0.05),low-grade disc degeneration (grades Ⅰ and Ⅲ) was significantly more frequent in the relapse group than in the control group.The patients with low-grade disc degeneration had a higher risk of recurrence,that was the risk of recurrent disc herniation increased by a factor of 4.4 from advanced disc degeneration to low-grade disc degeneration (OR =4.4,95% CI:1.983-9.765,P <0.05).In cases of recurrence,the time interval between primary surgery and the recurrence of the patient with advanced disc degeneration was longer compared with low-grade disc degeneration (r =0.733,P < 0.05).Conclusions Preoperative

  20. Short-term follow-up for artificial cervical disc replacement: Changes of stability and range of motion in cervical vertebra%人工颈椎间盘假体置换短期随访:颈椎稳定性及其运动范围变化

    Institute of Scientific and Technical Information of China (English)

    汤雪明; 徐南伟; 周栋; 蒋巍; 李海波

    2012-01-01

    背景:椎间盘摘除减压后的节段融合会限制节段的生理运动,造成邻近节段应力加大而导致其退变加速.目的:观察人工颈椎间盘植入假体治疗颈椎病短期随访中的稳定性及置换节段和颈椎整个节段的运动范围变化.方法:于2010-06/2011-08在常州市第二人民医院骨科共施行PCM钴铬合金颈椎间盘假体置换11例12个节段,男7例,女4例;脊髓型颈椎病8例,外伤性颈椎间盘突出3例.结果与结论:患者随访时间为3~12个月.置换后1,3,6个月以及末次随访时置换节段过屈过伸活动度、左右侧屈活动度与术前接近.置换后1个月、末次随访时患者日本矫形外科协会评分明显升高,而Oswestry颈椎功能障碍指数明显降低(P 0.05),同时X射线未发现假体松动、下沉或异位骨化等不良反应.提示PCM人工颈椎间盘置换后短期颈椎稳定功能活动效果较好.%BACKGROUND: Segment fusion after the discectomy decompression of cervical disc limits the physical exercise of the segment,which causes the accelerated degeneration due to increased stress of adjacent segment.OBJECTIVE: To observe stability and range of motion (ROM) in the replacement segment and cervical segment duringshort-term follow-up using artificial cervical disc replacement for the treatment of cervical disc disease.METHODS: Totally 11 cases (12 segments) who treated with cobalt-chromium alloy PCM cervical disc replacement fromDepartment of Orthopedics, the Second People's Hospital of Changzhou from June 2010 to August 2011 PCM were selectedincluding seven males and four females. Among these cases, there were eight cases with cervical myelopathy, and three caseswith traumatic cervical disc herniation.RESULTS AND CONCLUSION: All cases were followed-up for 3 to 12 months. ROM over flexion and extension, and flexionROM on lateral left and right were similar to preoperation at 1, 3, 6 months and final follow-up after replacement. Japaneseorthopaedic

  1. Anterior cervical fusion with the Caspar instrumentation system.

    Science.gov (United States)

    Naito, M; Kurose, S; Oyama, M; Sugioka, Y

    1993-01-01

    We reviewed 106 consecutive patients who had undergone anterior cervical fusion with the Caspar instrumentation system between 1984 and 1989. Preoperative diagnoses were cervical spondylosis in 73 patients, a traumatic lesion in 12, ossification of the posterior longitudinal ligament in 9, cervical disc herniation in 6, and tumour or miscellaneous lesions in 6. In the 106 patients, 56 had two levels fused and 27 had three levels fused. At an average duration of follow-up of 4 years and 7 months, nonunion occurred in 3 of the 83 patients with multiple level fusions. Screw loosening occurred in 8 of the 106 patients, but there was no oesophageal perforation.

  2. The role of CT discography in far lateral disk herniation

    Energy Technology Data Exchange (ETDEWEB)

    Koh, Hyun Shim; Yun, Seung Soo; Park, Jun Kyun; Kim, Young Chul; Kim, Young Sook; Oh, Jae Hee [College of Medicine, Chosun University, Kwangju (Korea, Republic of)

    1995-10-15

    To evaluate the value and the radiologic findings of CT discography in the diagnosis of the far lateral disk herniation. We retrospectively reviewed 7 cases of surgically proven far lateral lumbar disc herniation. CT discography was performed for all cases. Four cases underwent conventional CT and three cases MRI as a primary diagnostic imaging method. Far lateral diac herniation was divided into 3 groups by location; Intraforaminal herniation, extraforaminal herniation, and mixed type. We analyzed the findings of CT discography including location and extent of far lateral disc herniation. In all 7 cases, CT discography clearly demonstrated the filling of contrast media in laterally-protruded disc material. Intraforaminal and extraforminal types were seen in 2 cases each, and mixed type in 3 cases. Subligamentous herniated nucleus pulposus was present in 6 cases and extruded disc in 1 cases. Far lateral disc herniation was located at L4-5 in 5 cases and L5-S1 in 2 cases. CT discography can help establishing accurate preoperative diagnosis for far lateral disc herniation.

  3. 腰椎间盘突出症患者疼痛相关心理与生活质量的研究进展%Research progress on the state and life quality of pain-related psychological lumbar disc herniation patients

    Institute of Scientific and Technical Information of China (English)

    李星凤; 熊钰

    2016-01-01

    This article summarized the status quo of pain-related psychological and quality of life of patients with lumbar disc herniation, and provided a basis for improving the quality of life of patients with high risk of lumbar disc herniation.%通过总结腰椎间盘突出症患者疼痛相关心理和生活质量的现状,为提高腰椎间盘突出症高危人群的生活质量提供依据.

  4. Clinical and radiographic results of cervical artificial disc arthroplasty: over three years follow-up cohort study

    Institute of Scientific and Technical Information of China (English)

    TIAN Wei; HAN Xiao; LIU Bo; LI Qin; HU Lin; LI Zhi-yu; YUAN Qiang; HE Da; XING Yong-gang

    2010-01-01

    Background Theoretic advantages of cervical disc arthroplasty include preservation of normal motion and biomechanics in the cervical spine, and reduction of adjacent-segment degeneration. The clinical and radiographic effects of cervical disc arthroplasty in short term have been ascertained. The aim of this study is to research the data of mid-term results.Methods In this prospective cohort study, 50 patients who underwent cervical disc arthroplasty from December 2003 to January 2006 were enrolled. There were 39 patients who received 1-level disc arthroplasty, and 11 patients received 2-level disc arthroplasty, with an average age of 50.9 years (range from 29 to 73). The median follow-up was 41.85months (range from 36.00-55.63 months). Patients were followed prospectively with respect to their symptoms,neurologic signs, and radiographic results.Results The median value of Japanese Orthopaedic Association (JOA) score was 14.0 before surgery, and 16.5 at the most recent follow-up (P <0.01). The median value of the recovery rate of the JOA score was 92.2%. The preoperative range of motion (ROM) at the indexed level was (10.40±4.97)°, which has significantly correlated with the most recent follow-up ROM which was (8.56±4.76)° (P <0.05, r=0.33). The ROM at the operative level at the most recent follow-upwas greater than the value at the 3-month follow-up of (7.52±3.37)° (P <0.05). The preoperative functional spinal unit (FSU) angulation was (-0.96±6.52)°, which was not significantly correlated with that of the most recent follow-up value of (-2.65±7.95)° (P <0.01, r=0.53). The preoperative endplate angulation was (2.61±4.85)°, which had no significant correlation with that of the most recent follow-up value of (0.71±6.41)° (p >0.05).Conclusions The clinical and radiographic results of cervical disc arthroplasty are good in mid-term follow-up. The normal range of motion of the operated level and the biomechanics in the cervical spine are well

  5. Spinopelvic balance evaluation of patients with degenerative spondylolisthesis L4L5 and L4L5 herniated disc who underwent surgery

    Directory of Open Access Journals (Sweden)

    Viviane Regina Hernandez Nunes

    Full Text Available ABSTRACT OBJECTIVE: To correlate spinopelvic balance with the development of degenerative spondylolisthesis and disk herniation. METHODS: This was a descriptive retrospective study that evaluated 60 patients in this hospital, 30 patients with degenerative spondylolisthesis at the L4-L5 level and 30 with herniated disk at the L4-L5 level, all of whom underwent Surgical treatment. RESULTS: Patients with lumbar disk herniation at L4-L5 level had a mean tilt of 8.06, mean slope of 36.93, and mean PI of 45. In patients with degenerative spondylolisthesis at the L4-L5 level, a mean tilt of 22.1, mean slope of 38.3, and mean PI of 61.4 were observed. CONCLUSION: This article reinforces the finding that the high mean tilt and PI are related to the onset of degenerative spondylolisthesis, and also concluded that the same angles, when low, increase the risk for disk herniation.

  6. 经皮椎间孔入路全内镜技术治疗腰椎间盘突出症%Transforaminal percutaneous endoscopic lumbar discectomy for lumbar disc herniation

    Institute of Scientific and Technical Information of China (English)

    宋科冉; 李振宙; 侯树勋; 赵宏亮; 商卫林

    2014-01-01

    Transforaminal percutaneous endoscopic lumbar discectomy ( TF-PELD ) is a minimally invasive procedure, which has developed very fast recently. The appearance of Yeung Endoscopy Spine System ( YESS ) marked the maturation of TF-PELD. The YESS consists of a video system and a rigid endoscope including optical fiber lighting, wide-angle lens, some irrigation channels and a working channel. Inclusive lumbar disc herniation can be treated, but it is inadaptable for herniated lumber disc prolapsed in the canal. The cross-sectional area of the intervertebral foramen will be expanded by using Transforaminal Endoscopic Spine System ( TESSYS ), so as to put the working tube into the canal. The puncture point is moved outside and the working tube will be put into the canal in the“far-lateral technique”invented by Ruetten et al. The deifciency of YESS is offset by the 2 techniques stated above, and the operation indications of TF-PELD are extended. In recent 20 years, the side injuries have been constantly reduced and as good clinical results as in traditional decompression procedures have been achieved. TF-PELD will hold a bright prospect.

  7. 非手术疗法治疗腰椎间盘突出症156例疗效观察%Clinical Observation on 156 Cases of Lumbar Disc Herniation with Non-operative Therapy

    Institute of Scientific and Technical Information of China (English)

    齐笑千

    2013-01-01

    Objective:To observe the efficacy of finger-pressing, chiropractic and manual traction method treating lumbar disc herniation. Methods:156 cases of lumbar disc herniation were treated with finger-pressing, chiropractic and manual traction method. Results:Among 156 patients, 73 cas-es were cured, with 75 cases improved and 8 cases ineffective, the total efficiency was 94.9%. Conclusion:The three kinds of treatment, with short courses of treatment and obvious effects, are worthy of clinical promotion.%  目的:观察指压过伸法、定位整脊法、人工牵引法治疗腰椎间盘突出症的疗效。方法:采用指压过伸法、定位整脊法、人工牵引法对156例腰椎间盘突出症患者进行治疗。结果:156例患者中,治愈73例,好转75例,无效8例,总有效率94.9%。结论:通过该三法治疗,疗程短,效果明显,值得临床推广。

  8. Analgesic effects of balanced acupuncture versus body acupuncture in low-back and leg pain patients with lumbar disc herniation, as assessed by resting-state functional magnetic resonance imaging

    Institute of Scientific and Technical Information of China (English)

    Yongsong Ye; Bo Liu

    2012-01-01

    Balanced acupuncture, a single-acupoint balance therapy, regulates the balance of the cerebral center, and is characterized by exerting quick effects and a short treatment course. A total of 20 low-back and leg pain patients with lumbar disc herniation were treated with balanced acupuncture or body acupuncture. Central mechanisms of varied acupunctures were compared using rest-ing-state functional MRI. Patients from both groups received functional MRI before and after acu-puncture. Functional connectivity in brain regions that were strongly associated with the bilateral amygdala was analyzed utilizing AFNI software. Visual analogue scale scores were greater in the balanced acupuncture group compared with the body acupuncture group. Function of the endoge-nous pain regulation network was enhanced in patients in the balanced acupuncture group, but was not changed in the body acupuncture group. This result indicates that the analgesic effects of body acupuncture do not work through the central nervous system. These data suggest that balanced acupuncture exerts analgesic effects on low-back and leg pain patients with lumbar disc herniation by regulating the function of the endogenous pain regulation network.

  9. 经皮激光汽化减压术治疗腰椎间盘突出症的临床应用进展%Updates on the Clinical Application of Percutaneous Laser Disc Decompression to the treatment of Lumbar Disc Herniation

    Institute of Scientific and Technical Information of China (English)

    赵继荣; 孟彧; 陈文

    2013-01-01

    微创介入手术做为治疗腰椎间盘突出症(lumbar disc herniation,LDH)的有效方式在临床治疗中已得到肯定,其中经皮激光汽化减压术(percutaneous laser disc decompression,PLDD)是微创介入手术中较为理想的一种治疗方式.自1987年首次在临床应用并取得较好的疗效以来,PLDD治疗LDH已有20多年历史,本文就PLDD的研究背景及治疗原理、适应证及禁忌证、PLDD手术的应用现况、最新进展、存在的问题及展望等进行简要综述.%Minimally invasive operating methods have been proved to be effective interventions for lumbar disc herniation ( LDH) in clinic, especially among which percutaneous laser disc decompression (PLDD) is one of the ideal strategy. PLDD has been applied successfully to LDH for 20 years since 1987, the first time when it was used on LDH and achieved satisfied effect in clinic. In this paper, we summarized the research background, treating principle, indications, contraindications, application status, the latest progress, problems and prospects on PLDD.

  10. 本体感觉训练对腰椎间盘突出症的疗效%Effect of Proprioceptive Training on Lumbar Disc Herniation

    Institute of Scientific and Technical Information of China (English)

    陆伟伟; 阚世锋; 施海燕; 李旭; 郝又国

    2014-01-01

    目的:观察本体感觉训练治疗腰椎间盘突出症的效果。方法50例腰椎间盘突出症患者分成对照组(n=25)和治疗组(n=25)。两组均接受理疗和核心肌力训练,治疗组同时接受BIODEX平衡仪下本体感觉训练。治疗前和治疗8周后采用疼痛视觉模拟评分(VAS)、Oswestry下腰背功能障碍指数(ODI)、BIODEX平衡仪进行评定。随访1年,观察复发率。结果治疗后,两组患者VAS、ODI、稳定性极限指数与姿势性稳定指数均有改善(P<0.05),治疗组ODI、稳定性极限指数与姿势性稳定指数均优于对照组(P<0.05)。1年内,对照组复发5例,治疗组2例。结论本体感觉训练能进一步改善腰椎间盘突出症患者腰背功能,提高运动控制能力,降低复发率。%Objective To investigate the effects of proprioceptive training on lumbar disc herniation (LDH). Methods 50 patients with LDH were divided into experimental group (n=25) and control group (n=25). Both groups received physiotherapy and core stability exer-cise, and the experimental group received proprioceptive training with BIODEX Balanced System in addition. They were assessed with the Visual Analogous Scale (VAS) of pain, Oswestry Disability Index (ODI), and posture stability and limits of stability of BIODEX Balanced System. The incidence of relapse was followed up in a year. Results The scores of VAS, ODI, posture stability and limits of stability im-proved in both groups after treatment (P<0.05), and the ODI, posture stability and limits of stability improved more in the experimental group than in the control group (P<0.05). There were 5 cases relapsed in the control group, and 2 cases in the experimental group. Conclu-sion The proprioceptive training may further improve the function of lower back, and motor control in patients with LDH, and prevent the re-lapse.

  11. Deep needling Ashi point treatment of lumbar disc herniation%深刺阿是穴治疗腰椎间盘突出症

    Institute of Scientific and Technical Information of China (English)

    秦莉芳; 王小宁; 李文杰; 李霞; 王丽娜

    2015-01-01

    目的:观察深刺阿是穴治疗腰椎间盘突出症的临床疗效。方法将60例腰椎间盘突出症患者按随机对照试验方法分为2组。阿是穴组腰部取督脉、椎旁、足太阳膀胱经阿是穴深刺并配合患侧下肢辨经取穴。夹脊穴组腰部取双侧腰夹脊穴及患侧承山、阳陵泉、环跳、秩边。采用改良的日本骨科学会下腰痛评分系统及视觉模拟评分法分别观察。结果阿是穴组总有效率96.7%,夹脊穴组总有效率86.7%,2组比较差异有统计学意义( P<0.01),阿是穴组临床疗效优于夹脊穴组。结论深刺腰部阿是穴可以在局部形成较大的有效刺激量,配合患侧下肢辨经取穴治疗腰椎间盘突出症疗效确切。%Objective To observe the clinical efficacy of deep needling Ashi point treatment of Lumbar disc herniation (LDH) .Methods The 60 cases of LDH were randomly divided into 2 groups .Ashi group waist take Du meridian ,paraver-tebral ,bladder meridian Ashi point deep needling ,combined with selecting the acupoint by identifying meridian on sick lower extremity .The Jiaji group take bilateral lumbar Jiaji and affected side Chengshan ,Yanglingquan ,Huantiao ,Zhibian .Using the modified Japanese Orthopedic Association low lumbar pain score and Visual analogue score observe respectively .Results Ashi group the total efficiency 96 .7% ,Jiaji group the total effectiveness 86 .7% .Two groups'difference was statistically significant ( P<0 .01 ) .Ashi group clinical curative effect is better than Jiaji group .Conclusion Deep needling the waist Ashi point can form larger effective stimulating quantity in local .Deep needling the waist Ashi point treatment LDH has ob-vious curative effect ,combined with selecting the acupoint by identifying meridian on sick lower extremity .

  12. Early effect of lumbar dynamic fixation for treatment of lumbar disc herniation%腰椎动态植入物内固定系统治疗腰椎间盘突出症的早期疗效

    Institute of Scientific and Technical Information of China (English)

    明江华; 赵奇; 杨斌; 郑慧锋

    2014-01-01

    BACKGROUND:Currently, one of common methods is discectomy, nerve root decompression and fusion rigid fixation from the midline approach for disc herniation which is inefficient by conservative treatments. Thus, it is causing degeneration and limiting lumbar physiological activity of adjacent segments. The treatment of non-fusion lumbar disc herniation with the traditional posterior midline incision approach has some disadvantages such as big incision, wide peeling, and back muscle denervation. OBJECTIVE:To observe therapeutic effects of dynamic stabilization system through Wiltse approach on lumbar disc herniation, and to compare the outcomes with traditional posterior approach. METHODA total of 46 patients, who had undergone discectomy and internal fixation using dynamic stabilization systems for lumbar disc herniation at the Renmin Hospital of Wuhan University from January 2011 to January 2013, were enrol ed in this study. The operation was performed through the traditional posterior approach in 25 patients and Wiltse approach in 21 patients. RESULTS AND CONCLUSION:Al 46 patients were fol owed up for 7 to 31 months (averagely, 13.8±2.4 months). The length of incision, intraoperative blood loss, and postoperative drainage amount were less in the Wiltse approach group than in the traditional posterior approach group (P0.05). Radiographs revealed that the position of implants was good in al patients, no loosing or breakage. These data verified that the early effect of dynamic stabilization system through Wiltse approach for lumbar disc herniation is similar to that of traditional posterior approach.%背景:目前,对保守治疗无效的椎间盘突出症常用方法是经后正中入路髓核摘除、神经根管减压和刚性融合内固定,由此引起相邻节段的退变和腰椎生理活动受限是临床所面对的问题;而非融合固定的传统后正中入路则由于存在切口大、剥离广、腰背肌的失神经支配等缺点。  

  13. Comparison of 2 Zero-Profile Implants in the Treatment of Single-Level Cervical Spondylotic Myelopathy: A Preliminary Clinical Study of Cervical Disc Arthroplasty versus Fusion.

    Directory of Open Access Journals (Sweden)

    Sheng Shi

    Full Text Available Cervical disc arthroplasty (CDA with Discover prosthesis or anterior cervical discectomy and fusion (ACDF with Zero-P cage has been widely used in the treatment of cervical spondylotic myelopathy (CSM. However, little is known about the comparison of the 2 zero-profile implants in the treatment of single-level CSM. The aim was to compare the clinical outcomes and radiographic parameters of CDA with Discover prosthesis and ACDF with Zero-P cage for the treatment of single-level CSM.A total of 128 consecutive patients who underwent 1-level CDA with Discover prosthesis or ACDF with Zero-P cage for single-level CSM between September 2009 and December 2012 were included in this study. Clinical outcomes were evaluated using the Japanese Orthopaedic Association (JOA score and Neck Disability Index (NDI. For radiographic assessment, the overall sagittal alignment (OSA, functional spinal unit (FSU angle, and range of motion (ROM at the index and adjacent levels were measured before and after surgery. Additionally, the complications were also recorded.Both treatments significantly improved all clinical parameters (P 0.05. Besides, no significant differences existed in dysphagia, subsidence, or adjacent disc degeneration between the 2 groups (P > 0.05. However, significant differences occurred in prosthesis migration in CDA group.The results of this study showed that clinical outcomes and radiographic parameters were satisfactory and comparable with the 2 techniques. However, more attention to prosthesis migration of artificial cervical disc should be paid in the postoperative early-term follow-up.

  14. Chemonucleolysis in lumbar disc herniation: a meta-analysis Quimonucleólise em hernia de disco lombar: metanálise

    Directory of Open Access Journals (Sweden)

    José Mauro Cardoso Couto

    2007-01-01

    Full Text Available 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 (95% CI: 1.27-1.80. The summary estimate was 1.07 (95% CI: 0.95-1.20 for the comparison between chymopapain and collagenase. Regarding chemonucleolysis with chymopapain versus surgery, the fixed-effect summary estimate of effect for pain relief was 0.93 (95% CI: 0.88-0.98 with surgery as the reference group. In this case, heterogeneity was statistically significant. CONCLUSIONS: Chemonucleolysis with chymopapain was superior to placebo and was as effective as collagenase in the treatment of lumbar disc prolapse. Results for studies comparing chemonucleolysis with surgery were heterogeneous, making it difficult to interpret the summary measure of effect.OBJETIVO: Avaliar a eficácia da quimonucleólise no tratamento da hérnia de disco lombar por meio de uma metanálise de ensaios clínicos. MÉTODOS: Os ensaios clínicos foram selecionados de três bases de dados eletrônicas( Cochrane, MEDLINE, e EMBASE. Os dados foram analisados por intermédio do aplicativo STATA, com o comando meta. RESULTADOS: trabalhamos com 22 ensaios clínicos. Para a comparação entre quimonucleólise e placebo, a estimativa da razão de riscos, tendo melhora da dor como desfecho, foi de 1,51 (I 95% C: 1,27-1,80. Aquela medida foi de 1,07 (I 95% C: 0,95-1,20 para a comparação entre quimopapaína e colagenase. Em um modelo de efeitos fixos, a razão de risco, para melhora da dor, foi 0,93 (I 95% C: 0,88-0,98, tendo a discectomia como grupo de referência. Nesse caso, um teste de

  15. A study on the positive influence of Core muscle training on the lumbar disc herniation%核心肌群训练对腰椎间盘突出症的改善作用

    Institute of Scientific and Technical Information of China (English)

    曹犇; 尹德雷; 薛晋智

    2012-01-01

    To investigate the value of Core muscle training for the treatment of lumbar disc herniation. For 120 pa- tient with lumbar disc herniation had spent 5 months on core muscle training. In order to comparison and analysis of the affected part by combining spiral CT with MRI angiography technique. The results showed that the patients in the experimental group improved significantly more than the physiological curve of the reference group ( p 〈 0. 05) , The experimental group patients with whist pain and thigh numbness is greatly improved than the reference group [ p 〈 0. 01 ). The experimental conclusioned that through core muscle training can improve lumbar disc sur- rounding ligament tension, eliminating muscle adhesion , stabilization of the lumbar spine and other positive effects. It has important clinical value for the prevention and treatment of lumbar disc herniation.%探讨核心肌群训练在腰椎间盘突出症治疗中的价值。对120名腰椎间盘突出症患者进行了5个月的核心肌群训练。结合螺旋CT、MRI造影技术对患处进行分析对比。结果表明实验组患者生理曲线改善程度显著高于参照组(P〈0.05),实验组患者腰部疼痛感大腿麻木感较参照组有较大明显改善(P〈0.01)。实验结论:通过核心肌群训练能够明显改善腰椎间盘周围韧带驹牵张力消除肌肉粘连稳定腰椎等积极作用,对预防和治疗腰椎间盘突出症,防止再次复发具有重要的临床价值。

  16. Apply Comprehensive Nursing Intervention Model for Adolescents Suffering from Lumbar Disc Herniation%青少年腰椎间盘突出症患者负性情绪应用综合护理干预的作用

    Institute of Scientific and Technical Information of China (English)

    石瑞梅

    2013-01-01

    Objective:To apply comprehensive nursing intervention model for adolescents suffering from lumbar disc herniation in pa -tients during treatment the clinical effects of the implementation of nursing research .Methods:88 cases taken adolescents suffering from disc herniation using routine clinical care approach for patients with care for the control group ;adopt comprehensive nursing intervention model for the implementation of the observation group were nursing .Results:The patients with lumbar disc herniation treatment was signif-icantly better than the control group;emergence bad mood was significantly less than the number of patients in control group .Conclusion:Lumbar disc symptoms and treatment options to improve the implementation time was significantly shorter in the control group .%目的:对应用综合护理干预模式对患有腰椎间盘突出症的青少年患者在治疗期间实施护理的临床效果进行研究。方法:抽取88例患有腰椎间盘突出症的青少年患者,随机分为对照组和观察组,平均每组44例。采用临床常规腰椎间盘突出症护理方式对对照组患者实施护理;采用综合护理干预模式对观察组患者实施护理。结果:观察组患者腰椎间盘突出症治疗效果明显优于对照组;出现不良情绪的患者人数明显少于对照组;腰椎间盘突出症状改善时间和治疗方案实施时间明显短于对照组。结论:应用综合护理干预模式对患有腰椎间盘突出症的青少年患者在治疗期间实施护理的临床效果非常明显。

  17. Magnetic resonance imaging of traumatic cervical injury

    Energy Technology Data Exchange (ETDEWEB)

    Juhng, S. K.; Lee, K. S.; Sohn, K. J.; Choi, S. S.; Won, J. J. [Wonkwang University School of Medicine, Iri (Korea, Republic of)

    1994-04-15

    To evaluate magnetic resonance imaging (MRI) findings of cevical injuries. MRI studies of 34 patients with cervical spinal injuries were analyzed retrospectively. All MRI scans were obtained with an 1.0T superconductive MRI scanner (Siemens Magnetom 42SPE) and their findings were analyzed regarding the spinal cord, bony spine, ligaments, and intervertebral disks. A variety of abnormal findings were detected: 25 cord abnormalities including cord compression (15 cases), cord edema (4 cases), syringomyelia (4 cases), myelomalacia (1 case), and hemorrhagic contusion (1 case), 18 ligamentous injuries, 22 disk herniations (9 post-traumatic, 13 chronic degenerative), 11 spine fractures, and 4 subluxations. MRI is useful in evaluating the spinal cord itself, in depicting ligamentous injuries, in establishing the presence of disc herniation, and in assessing the alignment of cervical spine.

  18. Combined use of col4agenase injection with percutaneous lumbar diskectomy to treat lumbar disc herniation%联合应用髓核切吸与胶原酶盘内注射术治疗腰椎间盘突出症

    Institute of Scientific and Technical Information of China (English)

    鄂有国; 叶森

    2001-01-01

    目的:探讨提高经皮穿刺腰椎间盘髓核切吸术疗效的有效途径。方法:对50例腰椎间盘突出症病人行经皮穿刺腰椎间盘髓核切吸术后再注射胶原酶于椎间盘内。结果:有48例患者术后均获得满意疗效,其中包括10例有部分髓核组织脱入椎管的病人。结论:经皮穿刺腰椎间盘髓核切吸术后再注入胶原酶能明显提高疗效,对于突出程度较重的病人联合应用髓核切吸与胶原酶盘内注射术是一种有效的治疗方法。%Objective: To explore the effect of combined use of collagenase injection with percutaneous lumbar diskectomy for treating lumbar disc herniation. Methods: Fifty patients with lumbar disc herniation following percutaneous lumbar diskectomy were performed collagenase injection of lumbar disc. Results:48 patient, including 10 patients with partial nucleus pulposus herniation into spinal canal,obtained good responses after the above combined operation. Conclusion: Injecting collagenase into lumbar disc after percutaneous lumbar diskectomy can improve obviously curative effect of treating lumbar disc herniation. And it is an effective method of therapy for the patient suffering from serious lumbar disc herniation.

  19. 手术治疗腰椎间盘突出症的长期疗效及其影响因素%Long-term outcome of lumbar disc herniation surgery and its associated factors

    Institute of Scientific and Technical Information of China (English)

    陈新用; 梁裕; 曹鹏; 吴文坚; 郑涛; 张兴凯

    2012-01-01

    Objectives:. To evaluate the long-term outcome of surgical treatment for lumbar disc herniation and to investigate its associated factors. Methods: 125 cases suffering from lumbar disc herniation and undergoing discectomy at Ruijin Hospital from February 1996 to December 2002 were included in this study. All patients had single segment involved. The patients' gender, age, body mass index, disease course, clinical symptom, signs and the type of disc herniation were recorded. The postoperative recurrent disc herniation was also documented. The patients' functional conditions were reviewed by Oswestry disability index(ODI) pre- and postoperatively. Low back pain/leg pain was evaluated by visual analog scale(VAS). Stauffer-Coventry's(SC) e-valuation criteria was used in determining the patient's overall efficacy. Preoperative and final follow-up's VAS and ODI were analyzed by means of Univariate analysis. Considering overall clinical results as the variable outcome, the relationship between the outcome and 14 related factors such as age, gender, BMI, smoking, history of lumbar sprain, duration, preoperative VAS of low back pain/leg pain, preoperative ODI, SLR,muscle strength, sensation, segment and type of disc herniation were processed by univariate analysis. The association between variable outcome and 14 related factors was analyzed by means of multivariate logistical regression of the full model with all prognostic variables included and the model with the variables selected by the stepwise procedure. Results: The average follow-up was 109 months. The overall excellent/good/fair/poor rate was 32%, 35.2%, 23.2% and 9.6% respectively, and the recurrence rate was 8%. ODI decreased from (72.23±25.72)% preoperatively to (15.64±17.52)% at final follow-up, which had significant difference(P<0.05); VAS of low back pain decreased from 5.44±3.43 preoperatively to 2.12±2.32 at final follow-up, and VAS of leg pain decreased from 7.34+3.72 to 1.42±2.74. There were

  20. Research status of Clinical Efficacy on Different Position Traction Treating Lumbar Intervertebral Disc Herniation%不同体位牵引治疗腰椎间盘突出症临床疗效研究现状

    Institute of Scientific and Technical Information of China (English)

    陈庆庆; 黄艺; 王素珍

    2015-01-01

    腰椎间盘突出症是临床常见病、多发病,腰腿痛是其主要临床表现。手术治疗和非手术治疗是其最主要的治疗方法,尤其国内采用非手术治疗取得了近期和远期的满意疗效。牵引作为临床治疗腰椎间盘突出症的重要非手术疗法之一,无明显并发症,是一种基础、有效的治疗方法。本文将就牵引对腰椎间盘生物力学的改变、不同体位牵引治疗腰椎间盘突出症的临床疗效进行归纳总结。%Lumbar disc herniation is a kind of clinical common and frequently-occurring disease, low back pain is the main clinical manifestation. Surgical treatment and non-surgical treatment are the most common therapies, especially domestic non-surgical treatment has the short-term and long-term satisfaction efficacy. Traction is one of the most important non-operative treatment on lumbar disc herniation, without obvious complica-tion, which is a kind of basic and effective therapy. This article summarizes the biomechanics changes and clinical efficacy of traction on lumbar in-tervertebral disc protrusion.

  1. 体外高频热疗联合电针治疗腰椎间盘突出症疗效观察%Curative Effect of External High Frequency Thermotherapy Combined with Electroacupuncture on Lumbar Disc Herniation

    Institute of Scientific and Technical Information of China (English)

    闫广华; 常山; 张弘

    2015-01-01

    Objective To discuss the curative effect of external high frequency thermotherapy combined with electroacupuncture on intervertebral disc degerneration (IVDD). Methods 60 cases with lumbar disc herniation were divided into 2 groups:observation group and control group, 30 cases in each;external high frequency thermotherapy combined with electroacupuncture was performed on cases in observation group while the cases in control group were treated with electroacupuncture only;1 course lasted for 10 days, and after 2 courses, the clinical curative effects in the 2 groups were compared. Results The curative effect in observation group was much superior to that in control group (P<0.05). Conclusions The external high frequency thermotherapy combined with electroacupuncture is of good clinical effect on lumbar disc herniation.%目的:探讨体外高频热疗联合电针治疗腰椎间盘退变突出症的作用。方法将60例腰椎间盘突出症患者分为观察组与对照组,各30例。观察组采用体外高频热疗联合电针治疗,对照组采用电针治疗,10d/1疗程,治疗2个疗程后比较两组临床疗效。结果观察组临床疗效明显优于对照组(P<0.05)。结论体外高频热疗联合电针治疗腰椎间盘突出症有较好的临床效果。

  2. Non-contiguous spinal injury in cervical spinal trauma: evaluation with cervical spine MRI

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Soo Jung; Shin, Myung Jin; Kim, Sung Moon [University of Ulsan College of Medicine, Seoul (Korea, Republic of); Bae, Sang Jin [Sanggyepaik Hospital, Inje University, Seoul (Korea, Republic of)

    2004-12-15

    We wished to evaluate the incidence of non-contiguous spinal injury in the cervicothoracic junction (CTJ) or the upper thoracic spines on cervical spinal MR images in the patients with cervical spinal injuries. Seventy-five cervical spine MR imagings for acute cervical spinal injury were retrospectively reviewed (58 men and 17 women, mean age: 35.3, range: 18-81 years). They were divided into three groups based on the mechanism of injury; axial compression, hyperflexion or hyperextension injury, according to the findings on the MR and CT images. On cervical spine MR images, we evaluated the presence of non-contiguous spinal injury in the CTJ or upper thoracic spine with regard to the presence of marrow contusion or fracture, ligament injury, traumatic disc herniation and spinal cord injury. Twenty-one cases (28%) showed CTJ or upper thoracic spinal injuries (C7-T5) on cervical spinal MR images that were separated from the cervical spinal injuries. Seven of 21 cases revealed overt fractures in the CTJs or upper thoracic spines. Ligament injury in these regions was found in three cases. Traumatic disc herniation and spinal cord injury in these regions were shown in one and two cases, respectively. The incidence of the non-contiguous spinal injuries in CTJ or upper thoracic spines was higher in the axial compression injury group (35.5%) than in the hyperflexion injury group (26.9%) or the hyperextension (25%) injury group. However, there was no statistical significance ({rho} > 0.05). Cervical spinal MR revealed non-contiguous CTJ or upper thoracic spinal injuries in 28% of the patients with cervical spinal injury. The mechanism of cervical spinal injury did not significantly affect the incidence of the non-contiguous CTJ or upper thoracic spinal injury.

  3. The Application of DESS in the Diagnosis and Treatment of Far Lateral Lumbar Disc Herniation%双回波稳态进动磁共振序列在极外侧型腰椎间盘突出症诊治中的应用

    Institute of Scientific and Technical Information of China (English)

    泮智勇; 许茂盛; 丁雪委; 王世威; 庄汝杰

    2013-01-01

    Objective:To explore the display of DESS magnetic resonance sequence in FLLDH(far lateral lumbar disc herniation) and its value in the clinical diagnosis and treatment. Methods:Retrospective analysis of 9 cases of far lateral lumbar disc herniation in patients with lumbar MRI conventional sequence and DESS( double-echo steady-state precession) sequence of images,evaluate the application value of DESS sequence in clinical diagnosis and treatment of far lateral lumbar disc herniation. Results:The lumbar MRI sagittal insensitive to the diagnosis of extreme lateral lumbar disc herniation resulted in misdiagnosis and missed diagnosis in 9 cases of far lateral lumbar disc herniation; DESS sequence in the 9 patients images clearly show L4~5 lumbar intervertebral disc herniation in 5 patients,and L5S1 lumbar protrusion in the other 4 cases;herniation on the left side in 7 patients,herniation on the left side in 2 cases. Conclusion:The herniated lumbosacral nerve root entrapment can be clearly showed by DESS magnetic resonance scan image sequence in the far lateral lumbar disc herniation,it can improved accuracy for the diagnosis of lumbar disc herniation and play a great help for clinical physician in the intraoperative localization.%目的:探讨双回波稳态进动磁共振序列在极外侧型腰椎间盘突出症的显示情况及在临床诊治中的应用价值.方法:回顾性分析9例极外侧型腰椎间盘突出症患者的腰椎MRI常规序列和双回波稳态进动序列的图像,评价双回波稳态进动序列在极外侧型腰椎间盘突出症患者临床诊治中的应用价值.结果:由于腰椎MRI矢状位对极外侧型腰椎间盘突出症的诊断不敏感,造成9例极外侧型腰椎间盘突出症患者影像诊断上的误诊和漏诊;而双回波稳态进动序列在这9例患者的图像中明确显示L4-5腰椎间盘突出5例,L5S1腰椎间盘突出4例;其中左侧突出7例,右侧突出2例.结论:双回波稳态进动磁共振序列

  4. 腰椎间盘突出症与中医体质相关性的病例对照研究%Case-control Study on the Correlation between TCM Constitution and Lumbar Disc Herniation

    Institute of Scientific and Technical Information of China (English)

    白亚平; 王俊杰; 潘福萍

    2015-01-01

    Objective To investigate the correlation between TCM constitution and lumbar disc hernia-tion,and to provide new ideas and references for primary prevention and nursing by differentiating consti-tution.Methods By case-control study,150 cases of lumbar disc herniation patients were selected as case group and 150 cases of non-LDH patients from orthopedics and traumatology department were selected as control group.Also the TCM constitution of each group was determined according to the standardized ques-tionnaire of TCM constitution,rank sum test and logistic regression were then conducted.Results There were significant differences between the two groups in the distributions of Yang-deficiency,blood-stagna-tion and gentleness constitution(P<0.05).The Yang-deficiency and blood-stagnation were risk factors, while the gentleness constitution was protective factor.Conclusion Lumbar disc herniation was closely cor-related to the TCM constitution.The Yang-deficiency and blood-stagnation constitution were susceptibility constitution to lumbar disc herniation,thus,to adj ust these two partial constitutions actively was necessary for prevention and nursing care.%目的:探讨腰椎间盘突出症(lumbar disc herniation,LDH)与中医体质类型的相关性,为指导临床实践中的一级预防和“辨质施护”提供新的思路和参考依据.方法采用病例对照研究方法,收集2013年11月至2014年5月在浙江省中医院骨伤科住院及骨伤康复室就诊的 LDH 患者150例为病例组,同期来自骨伤科的150例非 LDH 患者为对照组,依据中医体质分类量表进行体质辨识,进行秩和检验及多因素 Logistic回归分析.结果两组患者的阳虚质、血瘀质、平和质分布的差异有统计学意义(P<0.05);其中阳虚质与血瘀质为 LDH 的危险因素,而平和质为保护因素.结论 LDH 的发生与体质密切相关,阳虚质、血瘀质是其发病的易感体质,在其防治及护理过程中应注意积极调整这两种偏颇体质.

  5. 探讨射频热凝联合臭氧髓核消融治疗腰椎间盘突出症的临床应用%Study of Radiofrequency Thermocoagulation Combined with Ozone Nucleus Pulposus Ablation in Treatment of Lumbar Disc Herniation Clinical Application

    Institute of Scientific and Technical Information of China (English)

    肖景舟; 伍艳阳; 许球祥

    2013-01-01

    Objective: To investigate the ozone nucleus pulposus ablation combined with radiofrequency thermocoagulation for the treatment of Lumbar Disc Herniation Clinical application. Methods:Select 90 cases in our hospital were suffering from lumbar disc herniation patients, divided into control group and treatment group, treated with ozone nucleus pulposus ablation combined with radiofrequency thermocoagulation in the treatment of lumbar disc herniation, the control group only with pure ozone nucleus pulposus ablation in treatment of lumbar disc herniation. Results:The total effective rate in treatment group was significantly higher than that of control group in the total efficiency. Conclusion:Ozone nucleus pulposus ablation combined with radiofrequency thermocoagulation in the treatment of lumbar disc herniation curative effect, safe and effective, and the clinical value.%  目的:探讨臭氧髓核消融联合射频热凝治疗腰椎间盘突出症的临床应用。方法:选取我院90例均患有腰椎间盘突出的患者,将其分为对照组和治疗组,治疗组采用臭氧髓核消融联合射频热凝治疗腰间盘突出,对照组采用单纯的臭氧髓核消融治疗腰间盘突出。结果:治疗组的总有效率明显大于对照组组的总有效率。结论:臭氧髓核消融联合射频热凝治疗腰间盘突出疗效显著,安全有效,且临床价值较高。

  6. 椎间盘镜下等离子刀髓核消融治疗钙化型腰椎间盘突出症%Effect of microendoscopic discectomy combined with radiofrequency coblation nucleoplasty on calcified lumbar disc herniation

    Institute of Scientific and Technical Information of China (English)

    陈宣煌; 李荣议; 陈金辉; 郑祖高; 张威; 林海滨

    2012-01-01

    Objective To investigate the feasibility and effect of radiofrequency coblation nucleoplasty combined with microendoscopic discectomy (MED) on calcified lumbar disc herniation.Methods A total of 35 patients with calcified lumbar disc herniation were choosed in the study.All patients were treated with microendoscopic discectomy.After general MED surgery,the remnant tissues were treated with radiofrequency coblation nucleoplasty.A follow-up was carried out for 12 months,and the effect of the surgery was evaluated.Results The operation was completed smoothly in all of the 35 patients.The excellent and good rate was 94.3%,according to Nakai classification.Conclusions MED combined with radiofrequency coblation nucleoplasty for treatment of the calcified lumbar disc herniation can expand the clinical indication of MED,as well as improve the clinical efficacy of MED.%目的 探讨后路显微内窥镜腰椎间盘切除术(MED)结合等离子刀手术系统微创治疗钙化型腰椎间盘突出症的可行性及疗效.方法 随机选择行MED下髓核摘除的钙化型腰椎间盘突出症患者35例,同时应用等离子刀对椎管内残余组织进行消融、皱缩,成形,术后随访,第12个月进行疗效评价.结果 35例患者均顺利完成此手术,Nakai治愈标准评估治疗效果,优良率为94.3%.结论 显微椎间盘镜结合等离子刀治疗钙化型腰椎间盘突出症,扩大了MED适应证范围,提高了椎间盘镜下髓核摘除术的临床疗效.

  7. 经皮穿刺切吸术治疗腰椎间盘突出症的疗效观察%Efficacy Observation on Automated Percutaneous Lumbar Discectomy Treating Lumbar Disc Herniation

    Institute of Scientific and Technical Information of China (English)

    雷安军

    2015-01-01

    Objective:To investigate the efficacy of automated percutaneous lumbar discectomy treating lumbar disc herniation. Methods:60 cases of lumbar disc herniation were randomly divided into control group and treatment group with each of 30 cases, control group with traditional conserva-tive therapy, treatment group treated with automated percutaneous lumbar discectomy, to observe the clinical efficacy and recurrence rate within 1 years of the two groups. Results: The total effective rate of experimental group was 96.67%, significantly higher than that of control group by 83.33%(P<0.05);the recurrence rate within 1 years of experimental group was significantly lower than that of control group (P<0.05). Conclusion:Automated percutaneous lumbar discectomy which has the advantages of simple operation, little trauma, fewer complications, faster recovery, little recurrence and the like, can significantly reduce the pain of patients with lumbar disc herniation, being worthy of clinical application.%目的:探讨经皮穿刺切吸术治疗腰椎间盘突出症的疗效。方法:60例腰椎间盘突出症患者随机分为对照组和治疗组各30例,对照组采用传统保守疗法,治疗组采用经皮穿刺切吸术治疗,观察两组患者临床疗效及1年内复发率。结果:实验组总有效率为96.67%,显著高于对照组的83.33%(P<0.05);实验组1年内复发率显著低于对照组(P<0.05)。结论:经皮穿刺切吸术具有操作简单、创伤小、并发症少、恢复快、不易复发等优点,可显著减轻腰椎间盘突出症患者的痛苦,值得临床推广应用。

  8. 二步六法推拿手法治疗腰椎间盘突出症30例疗效观察%Two-Step Six-Method Tuina Manipulation for 30 Cases of Lumbar Disc Herniation