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Search Results: 1 - 10 of 1331 matches for " Lumbar Disc Herniation "
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Lumbar Disc Herniation in Pediatric  [PDF]
Mostafa Abd Elsamea, Mohamed Shaban, Ahmed Taha, Samer Elshora
Open Journal of Modern Neurosurgery (OJMN) , 2018, DOI: 10.4236/ojmn.2018.82019
Abstract: Lumbar disc herniation is a common complaint among adults with degenerated lumbar intervertebral discs, however its incidence in childhood and adolescence is abundant. Findings recommended that pediatric lumbar disc herniation is dissimilar in numerous way from that in adults. It was confirmed that pediatric patients respond to conventional management less than adults, also the consequence of the operation continued to be acceptable for at least 10 years after the first surgery even though it seems to decline somewhat. This retrospective study was undertaken to determine the clinical outcome and the feature of lumbar disc prolapse in pediatric patients. 12 patients younger than 18 years were operated for lumbar disc prolapse in the period from 2012-2016. Patients preoperative data and radiological imaging, operative and postoperative follow up were reviewed. 12 patients were included in this study, 10 were male and 2 females, the average age was 15 years (ranging between 12 - 18 years). The average duration of the symptoms was 11 months. The average follow up was 14 months. All patients had a sciatica prior to surgery, 35% had motor deficit, and 60% had parasthesia. Conservative treatment failed in all patients. After surgery and follow up, improvement occurs in about 80% of patients, ranging from excellent to good, and 20% of patients with fair outcome. According to Pain Visual Analogue Scale, leg pain reduced from 90 - 30 and back pain from 80 - 35. Conclusion: Pediatric lumbar disc herniation is an uncommon object leading to hospitalization. About 0.1% - 0.2% of children and adolescence surgery for lumbar disc herniation in pediatric does not lead to chronic back pain or interfere with physical activity and is related to the excellent short consequence.
Percutaneous Endoscopic Lumbar Spine Surgery for Lumbar Disc Herniation and Lumbar Spine Stenosis: Emphasizing on Clinical Outcomes of Transforaminal Technique  [PDF]
Singh Ratish, Zeng-Xin Gao, Hirachan Mangal Prasad, Zhang Pei, Dangol Bijendra
Surgical Science (SS) , 2018, DOI: 10.4236/ss.2018.92007
Abstract: Lumbar Disc Herniation and Lumbar Spine Stenosis are the most common spine diseases which are mainly due to age related Spine degeneration. Diagnosis of both Lumbar Disc Herniation and Lumbar Spine Stenosis depends on clinical findings as well as radiological investigations. Treatment of choice of these conditions is on the basis of the patient conditions. Surgical treatment is the option only when the conservative treatment does not improve the patient’s clinical condition. Advancement and improvement of the technology have resulted in the traditional open surgical treatment into minimal invasive surgery. Intervention of the different surgical instruments with expert spinal surgeons had made percutaneous endoscopic lumbar Spine surgery as one of the preferred choices of surgery for treating Lumbar Disc Herniation and Lumbar Spine Stenosis. The concept of percutaneous endoscopic surgery for lumbar region is to provide surgical options without producing iatrogenic morbidity associated with the open surgical procedures. Conventionally, there are different approaches/techniques for Percutaneous Endoscopic Lumbar Spine Surgery, but in this review we are mainly focusing on the Transforaminal Technique. Regarding the Lumbar Disc Herniation treatment with transforaminal approach, a number of articles have been published due to which we mainly focused on those articles which were published after 2009 onwards. While fewer articles related to Lumbar Spine Stenosis treatment with Transforaminal approach were found, we tried to brief out all those articles. On the basis of comparative study of different surgeries done for Lumbar Disc Herniation and Lumbar Spine Stenosis, Percutaneous Transforaminal endoscopic Lumbar Surgery provides a substantial benefit. Transforaminal approach for treating Lumbar Disc Herniation and Lumbar Spine Stenosis is safe and effective. The Percutaneous Transforaminal Endoscopic Lumbar Surgery has advantage as it is performed under local anesthesia with shorter length of hospitalization and early return to normal life. The clinical outcome of the patient that underwent Percutaneous Transforaminal Endoscopic Lumbar Surgery for Lumbar Disc Herniation and Lumbar Spine Stenosis is quite good in regard of its fewer complication and more benefits.
Outcome Prediction in Lumbar Disc Herniation Surgery
Mirza Moranjkic,Zlatko Ercegovic,Mirsad Hodzic,Harun Brkic
Acta Medica Saliniana , 2010, DOI: 10.5457/ams.103.09
Abstract: Introduction: It is a well recognized fact that a significant proportion of patients operated on for lumbar disc herniation exhibit a poor outcome, regardless of the apparent technical success of the operative procedure itself. Aim: to identify a set of widely available variables that accurately predict short-term outcome after discectomy and to develop a predictive model based upon those variables. Patients and methods: Basic demographic, clinical and radiological variables were evaluated in a group of 70 patient operated on for disc herniation. Outcome was assessed using VAS and RM scales 6 months postoperatively and correlated to aforementioned variables. Results: Preoperative pain intensity and duration, age and type of disc herniation were all shown to be statistically significant predictors of short-term outcome, unlike sex, type of radiological investigation and preoperative tension sign testing results. Multivariate regression analysis including only variables previously identified as good outcome predictors revealed that the pain intensity exhibited the strongest correlation with outcome, followed by pain duration, type of disc herniation and age. Even though MR scan was more sensitive in detecting disc extrusion than CT (sensitivity of 100% versus 65%, respectively), the presence of preoperative MR scan did not influence the outcome. Conclusion: The study identified a set of widely available and easily attainable variables as fair predictors of short-term outcome after lumbar discectomy. Subsequent logistic regression resulted in a predictive model whose accuracy is to be determined in another prospective study.
Intradural and intraradicular lumbar disc herniations:Case report and review of the literature
Journal of Neurological Sciences , 2004,
Abstract: We presented two cases of intradural and intraradicular disc herniations respectively. Clinical presentation, diagnosis, pathogenesis, surgical treatment, and prognosis of the cases were discussed and our findings were in accordance with the literature. As a remark, MRI with gadolinium enhancement is a useful neuroradiological modality to reveal intradural disc herniations. In some cases, ruptured disc fragments can be detected in MRI but they may not be explored surgically at the involved intervertebral disc level. In such a case, if dura was found swollen and immobile, it should be incised and explored to exclude the possibility of a disc fragment. Urgent surgical intervention can significantly improve neurological outcome particularly in patients with cauda equina syndrome. Undiagnosed cases or the cases which was not achieved to remove extruded disc material completely constitute a portion of the cases with failed back syndrome.
Spontaneous Regression of Lumbar Disc Herniation: Report of Two Cases
Mehmet ?ENO?LU,Kas?m Zafer YüKSEL,Mürvet YüKSEL
Journal of Neurological Sciences , 2006,
Abstract: Spontaneous disc regression is described in lumbar, thoracic, cervical regions and also in various clinical situations. Although, spontaneous regression of lumbar disc herniation is a well defined clinical situation, the exact mechanism has not been adequately clarified yet. Currently , there are some suggested hypotheses. In this study, two cases with the complaint of lumbar radiculopathy and spontaneous regression of the disc herniation during their follow-up period, relevant with their clinical improvement and along with the radiological documentation of their situation, are presented. Possibility of the spontaneous regression of the lumbar discs and amelioration in some neurological symptoms with conservative therapy should be taken into account while giving a decision for operation on a patient with lumbar disc herniation.
The Clinical Outcomes of Transforaminal Percutaneous Endoscopic Discectomy in Treating Lumbar Disc Herniation: A Review  [PDF]
Bheemasetty Rakesh, Yun Tao Wang
Open Journal of Orthopedics (OJO) , 2018, DOI: 10.4236/ojo.2018.82008
Abstract: Percutaneous endoscopic lumbar discectomy (PELD) is a minimally invasive technique started during the late 20th century. This process is done through microscopic view under local anesthesia. There is a growing but still insufficient evidence that lumbar EDS shows slightly better results in terms of minor tissue damage, shorter hospital stay, faster return to ordinary daily activities, and patient satisfaction. Recurrence rate still remains a matter of debate, and is related with the surgical skills of the surgeon. The complication rate seems to be similar in both of the techniques i.e., open and endoscopic. More randomized controlled trials, systematic reviews and meta-analysis are needed to clarify whether lumbar EDS can be considered comparable if not superior to standard open discectomy. In spite of lacking defined clinical evidence, lumbar EDS is without doubt a rapidly expanding PELD and its future developments are incredibly promising. Due to less complication rate this technique can be considered as a gold standard compared to the open discectomy. The surgeons still require more cadaveric practices for learning the curve and to approach the herniated disc area. The main objective of this review article is to show the clinical outcomes of the Transforaminal Percutaneous Endoscopic Discectomy in treating the lumbar disc herniation.
Thoraco-Lumbar Junction Disc Herniation and Tight Filum: A Unique Combination?  [PDF]
Erwin M. J. Cornips, Emile A. M. Beuls, Biene W. Weber, Johannes S. H. Vles
International Journal of Clinical Medicine (IJCM) , 2014, DOI: 10.4236/ijcm.2014.512094

Purpose: The incidence of both symptomatic thoraco-lumbar junction disc herniation (TLJDH) and tight filum (TF) may be underestimated. Both conditions have a complex clinical presentation that may involve the distal spinal cord, conus medullaris, and/or cauda equina, including upper and/or lower motor neuron impairment, sensory impairment, urological and sexual dysfunction. The coexistence of both conditions has not been previously reported and may be a diagnostic and therapeutic challenge. Methods: We report three teenage girls, a 24-year-old woman, and two middle-aged women who were diagnosed with both conditions and treated at our institution. Results: Disc herniation level was T11-T12 in 2, T12-L1 in 3, and L1-L2 in one. All patients had a fatty filum (n = 5) and/or a low-lying CM (at or above L1-L2 in 2, at or below L2-L3 in 4), and were treated with filum sectioning first. All patients noted marked improvement of preoperative complaints including back pain (n = 5), leg pain and fatigue (n = 4), urological complaints (n = 4), and toe gait (n = 1). One 16-year-old girl successfully underwent a thoracoscopic microdiscectomy for persisting pain at the thoraco-lumbar junction two years after filum sectioning. Conclusions: Thoraco-lumbar junction disc herniation and tight filum both act on the distal spinal cord close to the transition to the cauda equina. Both conditions may coincide and may even act synergistically, the disc herniation acting as a fulcrum, aggravating the deleterious effect of the tethering force (and vice versa). This might explain why both conditions combined may present at a younger age. We suggest filum sectioning as the primary treatment option in all patients, however, more cases and a longer follow-up are needed to better understand their unique combination and interaction. Nevertheless, when confronted with a symptomatic TLJDH especially in young patients we advise to rule out a coinciding TF by careful consideration of all clinical, radiological, and urological data.

Technique of Percutaneous Transforaminal Endoscopic Discectomy for the Treatment of Lumbar Disc Herniation  [PDF]
Rama Shankar Gupta, Xiao-Tao Wu, Xin Hong, Arjun Sinkemani
Open Journal of Orthopedics (OJO) , 2015, DOI: 10.4236/ojo.2015.57028
Abstract: Percutaneous Transforaminal Endoscopic Discectomy is a minimally invasive surgery with little pain, less blood loss, less hospital stay and the surgery can be done in local anesthesia, which was started during late 20th century. Kambin and Gellmann in 1973 in the United States and Hijikata in Japanin 1977 individually preformed posterolateral percutaneous nucleotomy for the resection of the nucleus pulposus and release of compressed exiting nerve root, which is now spreading through the world and many surgeons are developing their skill but it needs experience and patience for successful outcomes. Along with advanced instruments now the surgery can be performed only giving a small skin incision of 8 - 10 mm and is as effective as the conventional method of surgery and open microdiscectomy surgery for the treatment of symptomatic lumbar disc herniation. In this review, we are explaining the technique of minimally invasive Percutaneous Transforaminal Endoscopic Discectomy surgery along its advantages and complications which can be encountered while performing this technique.
Scoliotic posture as the initial symptom in adolescents with lumbar disc herniation: its curve pattern and natural history after lumbar discectomy
Zezhang Zhu, Qinghua Zhao, Bin Wang, Yang Yu, Bangping Qian, Yitao Ding, Yong Qiu
BMC Musculoskeletal Disorders , 2011, DOI: 10.1186/1471-2474-12-216
Abstract: 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.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.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 a small curve size while assosiated with a significant coronal imbalance. Earlier decompression can provide a greater opportunity for spontaneous correction of scoliosis.Scoliotic posture has been found in coincidence with lumbar disc herniation (LDH) in both adolescents and adults [1-3]. Although the pathophysiology is not fully understood, scoliotic posture has been considered by most authors as a compensatory attempt
Hernia discal lumbar: algunos aspectos del diagnóstico
Rivero Torres,Rafael; álvarez Fiallo,Roger;
Revista Cubana de Medicina Militar , 2004,
Abstract: a cross-sectional descriptive study of 133 patients diagnosed with lumbar disc herniation l4-l5 and l5-s1 to evaluate some aspects of the diagnosis. more than two thirds were males for an approximate ratio 3:1. the most affected age groups were 30-39 and 40-49 years in both sexes. the most frequent symptom was lumbar pain (64,7 %); 71 patients progressed with the symptoms for over a year, 42 patients kept symptoms from 6 to 12 months and only 20 kept symptoms for less than 6 months. at the time of diagnosis, signs of prolonged compression were conformed in 86 patients (63,2 %). electromyography held the first place as far as positive electrophysiological studies are concerned (74,4 %). it was concluded that diagnosis of disease was late and determined electrophysiological alterations of prolonged compression that can not be solved with rehabilitation.
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