Outcomes From Magnetic Resonance Imaging–Confirmed Symptomatic Cervical Disk Herniation Patients Treated With High-Velocity, Low-Amplitude Spinal Manipulative Therapy: A Prospective Cohort Study With 3-Month Follow-Up

2013 ◽  
Vol 36 (8) ◽  
pp. 461-467 ◽  
Author(s):  
Cynthia K. Peterson ◽  
Christof Schmid ◽  
Serafin Leemann ◽  
Bernard Anklin ◽  
B. Kim Humphreys
Keyword(s):  
Magnetic Resonance Imaging ◽  
Cohort Study ◽  
Spinal Manipulative Therapy ◽  
Resonance Imaging ◽  
Disk Herniation ◽  
Manipulative Therapy ◽  
Cervical Disk Herniation ◽  
Low Amplitude ◽  
Cervical Disk

scholarly journals Posterior Endoscope-Assisted Diskectomy Is an Effective Technique for Cervical Soft Disk Herniation

2021 ◽  
Author(s):  
Derya Gündoğdu Karaoglu ◽  
Omer Polat ◽  
Ozhan Merzuk Uckun ◽  
Resul Karadeniz ◽  
Deniz Belen ◽  
...  
Keyword(s):  
Rating Scale ◽  
Treatment Method ◽  
Disk Herniation ◽  
Scale Scores ◽  
Cervical Disk Herniation ◽  
The Mean ◽  
Outcome Rating Scale ◽  
Soft Disk ◽  
Cervical Disk

Abstract Objective To evaluate the clinicoradiologic conditions of patients with a herniated cervical disk who were treated with percutaneous endoscope-assisted cervical diskectomy. Materials and Methods The medical data of 27 patients (16 men and 11 women; mean age: 40.9 years) who were operated on with the posterior endoscope-assisted cervical diskectomy method were reviewed retrospectively. The mean follow-up was 35.1 months, and the patients were assessed with combined preoperative and postoperative visual analog scale (VAS), Prolo Functional Economic Outcome Rating scale, MacNab scale, and clinical imaging. Results The mean preoperative VAS level was 8.6 (range: 7–10), and mean Prolo score was 2.5 (range: 2–5). A postoperative assessment performed 1 week postsurgery found a mean VAS level of 2.1 (range: 0–4). At the final examination, the mean VAS level was 0.81 (range: 0–3), and the mean Prolo score was 4.5 (range: 3–5). The final MacNab scale scores were 62.9%, excellent; 25.9%, good; 7.4%, moderate; and 3.7%, poor. Conclusion Percutaneous endoscope-assisted cervical diskectomy is a suitable and effective treatment method for soft cervical disk herniation.

scholarly journals Ultrasonic Osteotome Assisted Full-Endoscopic en Block Resection of Thoracic Ossified Ligamentum Flavum: Technical Note and 2 Years Follow-up

2021 ◽  
pp. E239-E248
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Spinal Cord ◽  
Cohort Study ◽  
Back Pain ◽  
Thoracic Spine ◽  
Ligamentum Flavum ◽  
Radicular Pain ◽  
Resonance Imaging

BACKGROUND: Conventional open laminectomy is considered to be the standard procedure for the treatment of thoracic ossified ligamentum flavum, but multi-segment thoracic laminectomy extensively removes the facet joints and ligamentous tissue, destroying the thoracic spine biomechanics and stability, may lead to delayed thoracic spine kyphosis deformities, which in turn can lead to potential neurological deterioration and local intractable pain. OBJECTIVE: To introduce the technical notes and clinical outcome of ultrasonic osteotome assisted full-endoscopic en block resection of thoracic ossified ligamentum flavum. STUDY DESIGN: A prospective cohort study. SETTING: Hospital and outpatient surgery center. METHODS: From January 2017 to March 2018, 15 patients with 1 – 2 segment thoracic ossified ligamentum flavum were treated with ultrasonic osteotome assisted full-endoscopic en block resection of thoracic ossified ligamentum flavum under local anesthesia. The magnetic resonance imaging and computed tomography of the thoracic spine was reexamined after the operation to evaluate the completeness of ossified ligamentum flavum resection and spinal cord decompression. The patients were followed up on the visual analogue scale of back pain and radicular pain, Nurick score and mJOA score of neurological function, and Oswestry Disability Index at 1 week, 3 months, 6 months, one year, and 2 years after operation. RESULTS: All operations of 17 segments thoracic ossified ligamentum flavum in 15 patients were successfully completed without intraoperative conversion to open surgery. There were no intraoperative spinal cord injuries, dura tears, postoperative cerebrospinal fluid leakage, postoperative infections, and postoperative spinal cord injury aggravated symptoms. Postoperative thoracic spine magnetic resonance imaging and computed tomography examinations of all patients showed that the spinal cord was fully decompressed without any residual pressure. Back pain and radicular pain were relieved significantly, and spinal cord function (Nurick, mJOA, and Oswestry Disability Index scores) was obviously restored. The mJOA recovery rate at the 2-year follow-up was 78.3% in average. LIMITATIONS: This is an observational cohort study with relative small sample and short-term follow-up. CONCLUSIONS: Ultrasonic assisted full-endoscopic en block resection of ossified ligamentum flavum is a safe and effective minimally invasive spine surgery for thoracic myelography caused by thoracic ossified ligamentum flavum. KEY WORDS: Thoracic myelopathy, ossified ligamentum flavum, full-endoscopic decompression, ultrasonic osteotome, minimally invasive surgery

Follow-Up MRI for Sciatica

2016 ◽  
Author(s):  
Christoph I. Lee
Keyword(s):  
Magnetic Resonance Imaging ◽  
Back Pain ◽  
Clinical Implications ◽  
Resonance Imaging ◽  
Disk Herniation ◽  
Clinical Context ◽  
Additional Information ◽  
Study Methodology ◽  
Magnetic Resonance Imaging Mri

This chapter, found in the back pain section of the book, provides a succinct synopsis of a key study examining the use of follow-up magnetic resonance imaging (MRI) for patients with sciatica. This summary outlines the study methodology and design, major results, limitations and criticisms, related studies and additional information, and clinical implications. Researchers concluded that the presence of disk herniation on MRI at 1-year follow-up after treatment for sciatica does not help distinguish between favorable and unfavorable clinical outcomes. In addition to outlining the most salient features of the study, a clinical vignette and imaging example are included in order to provide relevant clinical context.

scholarly journals Use of Preoperative Magnetic Resonance Imaging to Predict Clinical Outcomes After Core Muscle Injury Repair

2021 ◽  
Vol 9 (4) ◽  
pp. 232596712199580
Author(s):  
Matthew J. Kraeutler ◽  
Jennifer Kurowicki ◽  
Iciar M. Dávila Castrodad ◽  
Edward Milman ◽  
Toghrul Talishinskiy ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Cohort Study ◽  
Magnetic Resonance ◽  
Physical Examination ◽  
Clinical Outcomes ◽  
Muscle Injury ◽  
Resonance Imaging ◽  
Ucla Activity Score ◽  
Significant Difference

Background: Core muscle injury (CMI), often referred to as a sports hernia or athletic pubalgia, is a common cause of groin pain in athletes. Imaging modalities used to assist in the diagnosis of CMI include ultrasound (US) and magnetic resonance imaging (MRI). Purpose: To determine if preoperative MRI findings predict clinical outcomes after surgery for CMI. Study Design: Cohort study; Level of evidence, 3. Methods: A retrospective cohort study was performed on a consecutive series of patients who were operatively treated for CMI by a single surgeon. CMI was diagnosed based on history, physical examination, and a positive US. In addition, all patients underwent a preoperative MRI. Patients were divided into 2 groups based on whether the MRI was interpreted as positive or negative for CMI. All patients underwent mini-open CMI repair. Patient-reported outcomes (PROs) were collected both pre- and postoperatively and included a visual analog scale (VAS) for pain, the University of California, Los Angeles (UCLA) activity score, and the modified Harris Hip Score. Results: A total of 39 hips were included in this study, of which 17 had a positive MRI interpretation for CMI (44%) and 22 had a negative MRI interpretation (56%). Mean age at the time of surgery was 35 years (range, 17-56 years), and mean follow-up was 21 months (range, 12-35 months). No significant difference was found between groups in mean age or time to follow-up. Patients in both groups demonstrated significant improvement from preoperative to most recent follow-up in terms of the UCLA activity score ( P < .05). VAS scores significantly improved for patients with a positive MRI interpretation ( P = .001) but not for those with a negative MRI interpretation ( P = .094). No significant difference on any PROs was found between groups at the most recent follow-up. Conclusion: Successful clinical outcomes can be expected in patients undergoing surgery for CMI diagnosed based on history, physical examination, and US. Patients with a preoperative MRI consistent with CMI may experience greater improvement in pain postoperatively, although MRI does not predict postoperative activity level in these patients.

Sign in / Sign up

Export Citation Format

Share Document