Thoracic Disc Herniation Mimicking Acute Lumbar Disc Disease

Abstract Purpose Surgical treatment failures or strategies for the reoperation of residual thoracic disc herniations are sparsely discussed. We investigated factors that led to incomplete disc removal and recommend reoperation strategies. Methods As a referral centre for thoracic disc disease, we reviewed retrospectively the clinical records and imaging studies before and after the treatment of patients who were sent to us for revision surgery for thoracic disc herniation from 2013 to 2018. Results A total of 456 patients were treated from 2013 to 2018 at our institution. Twenty-one patients had undergone previously thoracic discectomy at an outside facility and harboured residual, incompletely excised and symptomatic herniated thoracic discs. In 12 patients (57%), the initial symptoms that led to their primary operation were improved after the first surgery, but recurred after a mean of 2.8 years. In seven patients (33%) they remained stable, and in two cases they were worse. All patients were treated via all dorsal approaches. In all 21 cases, the initial excision was incomplete regarding medullar decompression. All of the discs were removed completely in a single revision procedure. After mean follow-up of 24 months (range 12–57 months), clinical neurological improvement was demonstrated in seven patients, while three patients suffered a worsening and 11 patients remained stable. Conclusion Our data suggest that pure dorsal decompression provides a short relief of the symptoms caused by spinal cord compression. Progressive myelopathy (probably due to mechanical and vascular deficits) and scar formation may cause worsening of symptoms. Graphic abstract These slides can be retrieved under Electronic Supplementary Material.

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Outcome of Surgical Treatment for Lumber Disc Herniation Causing Painful Incomplete Foot-Drop

Pakistan Journal Of Neurological Surgery ◽

10.36552/pjns.v24i3.398 ◽

2020 ◽

Vol 24 (3) ◽

Author(s):

MUSAWER KHAN ◽

AKRAM ULLAH ◽

ADNAN AHMED ◽

MUMTAZ ALI ◽

MANSOOR AHMAD

Keyword(s):

Surgical Treatment ◽

Pain Relief ◽

Disc Herniation ◽

Lumbar Disc ◽

Cauda Equina ◽

Foot Drop ◽

Disc Disease ◽

Lumbar Disc Disease ◽

Number Of Patients

Objective: To determine the outcome of surgical treatment for lumder disc herniation causing the painful incomplete foot drop. Material and Methods: This retrospective observational study was conducted at the Department of Neurosurgery Lady Reading Hospital, Peshawar. Both Male and female patients with lumbar disc disease causing unilateral incomplete painful foot drop were included in our study. Patients with complete or painless foot drop, bilateral foot-drop, Multiple level disc prolapse, cauda equina syndrome or sciatic neuropathy due to injection injury were excluded. Patients were followed was post-operatively in terms of power in foot dorsiflexion, medical research council (MRC) grade and pain relief on a Visual Analogue Scale (VAS) after 1 month and then after 6 months. Results: Total number of patients included were 43. Age was ranging from 18 years to 54 years and mean age was 33 years. Before surgery, power of MRC grade 3 or less, but greater than 1 in dorsiflexion was noted in all patients. The pain was scaled using VAS. Post peratively, at 1 month follow up, the foot-drop improved to MRC grade 4 or 5 along with pain relief of ≥ 2 points on VAS in 81. 4% (n = 35) patients and at 6 month follow-up, the figure rose to 93% (n = 40). Conclusion: Lumbar disc disease can cause a debilitating foot-drop and pain. Improving or restoring a neurology early surgical intervention has proven benefits.

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Thoracic Disc Disease

10.1093/med/9780199350940.003.0009 ◽

2018 ◽

Author(s):

Ankur P. Dave

Keyword(s):

Back Pain ◽

Clinical Presentation ◽

Imaging Techniques ◽

Lumbar Disc ◽

Treatment Options ◽

Disc Disease ◽

Lumbar Disc Disease ◽

Chronic Pain Patients ◽

Thoracic Disc ◽

Pain Patients

This chapter discusses thoracic disc disease (TDD), an overlooked condition affecting many chronic pain patients. TDD is rare and often misdiagnosed as cervical or lumbar disc disease. Given the various causes for mid-back pain, a thorough understanding of TDD is vital for the appropriate management of this patient population. This section will discuss the pathophysiology, clinical presentation, diagnostic evaluation (including imaging techniques), and treatment options for this condition. The chapter emphasizes the importance of considering TDD in the differential diagnosis for patients suffering from chronic mid-back pain.

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A 6.5-year follow-up of 14 patients who underwent ProDisc total disc arthroplasty for combined long-standing degenerative lumbar disc disease and recent disc herniation

Journal of Clinical Neuroscience ◽

10.1016/j.jocn.2011.04.024 ◽

2011 ◽

Vol 18 (12) ◽

pp. 1677-1681 ◽

Cited By ~ 8

Author(s):

Thomas-Marc Markwalder ◽

Markus Wenger ◽

Serge Marbacher

Keyword(s):

Disc Herniation ◽

Lumbar Disc ◽

Total Disc Arthroplasty ◽

Disc Disease ◽

Lumbar Disc Disease ◽

Disc Arthroplasty

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A case of intradural lumbar disc herniation

10.22541/au.163443336.68988228/v1 ◽

2021 ◽

Author(s):

Utsav Bhattarai ◽

Pritam Gurung ◽

Janam Shrestha ◽

Sudan Dhakal ◽

Samir Acharya ◽

...

Keyword(s):

Lumbar Disc Herniation ◽

Disc Herniation ◽

Histopathological Examination ◽

Lumbar Disc ◽

Postoperative Outcome ◽

Intraoperative Ultrasonography ◽

Resected Specimen ◽

Disc Disease ◽

Lumbar Disc Disease ◽

Rare Phenomenon

Lumbar disc herniation into the dural space is a rare phenomenon of degenerative lumbar disc disease and its pathogenesis remains unclear. Intraoperative ultrasonography and histopathological examination of resected specimen aids in diagnosis of intradural disc herniation.Prompt surgery is recommended as postoperative outcome of the patient at our setting was favourable.

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Coexistence of Hip Torsional Deformities in Patients With Lumbar Disc Herniation; A Case-Control Study

Turkish Journal of Hip Surgery ◽

10.5222/tjhs.2021.36855 ◽

2021 ◽

Author(s):

Yağmur Işın ◽

Erol Kaya ◽

Onur Hapa ◽

Ceren Kızmazoğlu ◽

Onur Gürsan ◽

...

Keyword(s):

Lumbar Spine ◽

Disc Herniation ◽

Causal Relation ◽

Lumbar Disc ◽

Clinical Findings ◽

Acetabular Anteversion ◽

Disc Disease ◽

Lumbar Disc Disease ◽

Control Subjects ◽

Flexion Extension

Objective: Coexistence of lumbar spine disorder with hip diseases is defined as Hip-Spine syndrome, there might be a relation between torsional deformities of the hip and lumbar disc disease. Purpose of the present study was to find whether hip torsional parameters (femur, acetabular anteversion) and clinical findings (hip range of motion, hip score) differ in patients with lumbar disc disease. Method: Patients with lomber disc herniation (n: 20) and control subjects (n: 20) without any lumbar spine or hip disease were enrolled in the study. Femoral anteversion (FeAv), acetabular anteversion (AA), center of edge angle (CE), degree of hip flexion, extension, Harris Hip scores (HHS) were evaluated bilaterally. Results: HHS score, degree of extension plus flexion was lower at diseased side when it is compared to the control subjects (p < 0.001). Unilaterally affected patients had lower AA than control subjects (AA: 13 ± 40 vs16 ± 20 p: 0.01). Conclusion: As there is a link between hip and spine disorders, present study aims to find whether there is a causal relation between hip torsional deviations and lumbar disc disease. Partially supporting the hypothesis, diseased side had lower degrees of acetabular anteversion compared to control subjects at unilaterally affected patients. Mechanical and /or hip torsional parameters especially the acetabular retroversion may have an etiopathogenetic role in unilateral lumbar disc disease.

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Clinical and Functional Results of Patients with Surgically Treated Single Level Lumbar Disc Disease: Comparative Analysis of Patients with Disc Herniation, Stenosis of the Spinal Canal, and Lumbar Spondylolisthesis

Global Spine Journal ◽

10.1055/s-0035-1554540 ◽

2015 ◽

Vol 5 (1_suppl) ◽

pp. s-0035-1554540-s-0035-1554540

Author(s):

Asdrubal Falavigna ◽

Orlando Righesso ◽

Alisson Roberto Teles ◽

Pedro Guarise da Silva ◽

Lucas Piccoli Conzatti ◽

...

Keyword(s):

Comparative Analysis ◽

Disc Herniation ◽

Spinal Canal ◽

Lumbar Disc ◽

Functional Results ◽

Disc Disease ◽

Lumbar Disc Disease ◽

Single Level ◽

Lumbar Spondylolisthesis

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Preoperative paraspinal and psoas major muscle atrophy and paraspinal muscle fatty degeneration as factors influencing the results of surgical treatment of lumbar disc disease

Archives of Orthopaedic and Trauma Surgery ◽

10.1007/s00402-021-03754-x ◽

2021 ◽

Author(s):

Agnieszka Stanuszek ◽

Adrian Jędrzejek ◽

Eliza Gancarczyk-Urlik ◽

Izabela Kołodziej ◽

Magdalena Pisarska-Adamczyk ◽

...

Keyword(s):

Surgical Treatment ◽

Muscle Atrophy ◽

Lumbar Disc ◽

Fatty Degeneration ◽

Paraspinal Muscle ◽

Disc Disease ◽

Lumbar Disc Disease ◽

Factors Influencing ◽

Psoas Major Muscle ◽

Psoas Major

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Does the Intradiscal Injection of Platelet Rich Plasma Have Any Beneficial Role in the Management of Lumbar Disc Disease?

Global Spine Journal ◽

10.1177/2192568221998367 ◽

2021 ◽

pp. 219256822199836

Author(s):

Sathish Muthu ◽

Madhan Jeyaraman ◽

Girinivasan Chellamuthu ◽

Naveen Jeyaraman ◽

Rashmi Jain ◽

...

Keyword(s):

Beneficial Effect ◽

Platelet Rich Plasma ◽

Lumbar Disc ◽

Meta Analysis ◽

Cochrane Library ◽

Significant Heterogeneity ◽

Disc Disease ◽

Lumbar Disc Disease ◽

Beneficial Role ◽

Sf 36

Study Design: Systematic review and meta-analysis. Objectives: We performed this meta-analysis to evaluate whether intradiscal Platelet Rich Plasma(PRP) injection has any beneficial role in the management of lumbar disc disease. Methods: We conducted independent and duplicate electronic database searches including PubMed, Embase, and Cochrane Library till September 2020 for studies investigating the role of intradiscal PRP in the management of lumbar disc disease. The analysis was performed in the R platform using OpenMeta[Analyst] software. Results: 13 studies including 2 RCTs, 5 prospective, and 6 retrospective studies involving 319 patients were included in the meta-analysis. A single-arm meta-analysis of the included studies showed a beneficial effect of the intervention in terms of pain relief outcomes like VAS score (p < 0.001), pain component of SF-36 (p = 0.003) while such improvement was not seen in functional outcome measures like ODI score (p = 0.071), the physical component of SF-36 (p = 0.130) with significant heterogeneity noted among the included studies. No structural improvement in magnetic resonance imaging was observed (p = 0.106). No additional procedure-related adverse events were noted in the included studies (p = 0.662). Conclusion: There is a paucity of high-quality studies to give conclusive evidence on the benefits of intradiscal PRP for lumbar disc disease. Although intradiscal PRP injection has shown some beneficial effect in controlling pain for lumbar disc disease, we could not find structural or functional improvement from the included studies. Hence, we recommend large double-blind double-arm randomized controlled studies to analyze the benefits of the intervention being analyzed.

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