Percutaneous Treatment of Herniated Lumbar Disc by Intradiscal Oxygen-Ozone Injection

1998 ◽  
Vol 4 (4) ◽  
pp. 279-286 ◽  
Author(s):  
M. Muto ◽  
F. Avella
Keyword(s):  
Physical Therapy ◽  
Neurological Deficit ◽  
Lumbar Disc ◽  
Plain Film ◽  
Percutaneous Treatment ◽  
Radicular Pain ◽  
Herniated Disc ◽  
Clinical Recovery ◽  
Herniated Lumbar Disc ◽  
Intradiscal Injection

We report our experience of treating lumbar herniated disc by intradiscal injection of an oxygen-ozone mixture. Ozone (03, MW = 48) is a triatomic molecule, having antiviral, disinfectant and antiseptic properties. Several mechanisms of action have been proposed to explain the efficacy of the treatment: analgesic action; anti-inflammatory action; oxidant action on the proteoglycan in the nucleus pulposus. We treated 93 patients (50 women, 43 men) aged from 24 to 45 yrs (average age 38 yrs) from June 1996 to April 1998. All patients presented sciatica and/or low back pain, lasting two or more months; patients had in the mean time received both medical and physical therapy with mild or no benefit. Diagnostic tests in all patients included plain film x-ray, CT and/or MR at the level of the lumbar spine disclasing a herniated or protruded disc with nerve root or thecal sac compression. We divided patients to be treated in to two groups: the first one group included 35 patients already selected for surgery who presented herniated or protruded disc with radicular pain with associated neurological deficit (hypoesthesia and partial loss of reflex). Those patients had already had medical and physical therapy for two or more months and agreed to try the percutaneous treatment before surgery. CT or MR in this group demonstrated the presence of intraforaminal, extra or sub-ligamentary and sequestrated herniated disc. The second group included 58 patients with radicular pain but without neurological deficit; patients in this group had received medical and/or physical therapy for two or more months and CT showed the presence of a small subligamentary herniated or protruded disc. We considered the results according to the modified MacNab method. In the first group we had “failure” in all patients; in seven cases the symptoms improved for one month, but recurred later on. In the second group 45 patients had “success” showing complete clinical recovery within five to six days after treatment, all remained without symptoms up to six months or more of follow-up. The remaining 13 patients presented the same symptoms again within three months after a temporary clinical recovery. The goal of this study was to present this new technique that can also be compared with a previous study of different percutaneous treatment. Clinical and neuroradiological indications and the contraindications are well known, and must be followed to achieve good results and avoid complications.

EFFECTIVENESS OF EPIDURAL STEROID INJECTION FOR THE MANAGEMENT OF CHRONIC LOW BACK PAIN.

2021 ◽  
pp. 52-54
Author(s):  
Ravi Ranjan Singh ◽  
Bharat Singh
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Steroid Injection ◽  
Lumbar Disc ◽  
Radicular Pain ◽  
Epidural Steroid Injection ◽  
Low Back ◽  
Herniated Lumbar Disc ◽  
Epidural Steroid

INTRODUCTION: Low-back pain is a common clinical presentation of herniated lumbar disc. The incidence of low back pain is high in our country due to difcult working and living environment. The initial treatment of low back pain is conservative. Epidural steroid injection (ESI) is being slowly established as a simple, effective and minimally invasive treatment modality. The aim of this study is to assess the effectiveness of epidural steroid injection for low back and radicular pain. MATERIALS AND METHODS :This is a Prospective observational study. It was carried out on the patients presenting with low back pain due to herniated lumbar disc not responding to conservational management and had Magnetic Resonance Imaging (MRI) proven lumbar disc prolapsed at different level. Injection Methyl prednisolone 80 mg and 2 ml of 0.5% bupivacaine was diluted in 8 ml of normal saline and injected into the affected lumbar epidural space. The functional status of the patient and the severity of pain were evaluated before injection and after injection during the follow-up period by using Ostrewy disability index and visual analogue score. RESULTS: Fifty six patients received the epidural steroid injections, among them three patients did not came for regular follow up till six months and six patients required surgery . remaining forty seven were analyzed , among them 27(55.44%) were male and 20(42.55%) were female. The functional status and pain response of the patients were improved signicantly during all the follow-up periods (p < 0.001). The success rate of this study was 83.92%. No major complications were encountered. CONCLUSION:The ESI is a simple, safe, effective and minimally invasive modality for the management of lumbar radicular pain.

Syndrome of the incidental herniated lumbar disc

1983 ◽  
Vol 59 (1) ◽  
pp. 137-141 ◽  
Author(s):  
James E. Wilberger ◽  
Dachling Pang
Keyword(s):  
Clinical Features ◽  
Lumbar Disc Herniation ◽  
Lumbar Disc ◽  
Herniated Disc ◽  
Content Type ◽  
Asymptomatic Patients ◽  
Appropriate Treatment ◽  
Herniated Lumbar Disc ◽  
Fine Print

✓ Lumbar myelographic defects consistent with herniated disc were found in 108 asymptomatic patients undergoing myelography for other reasons. Within 3 years, 64% of these patients developed symptoms of lumbosacral radiculopathy. The clinical features of these patients comprise a syndrome significantly different from that typically associated with classical lumbar disc herniation: the syndrome described here carries a much higher incidence of silent root compression with minimal pain. Incidental lumbar myelographic defects are not necessarily benign findings, and patients in whom they are encountered deserve close clinical follow-up review and appropriate treatment if the defects become symptomatic.

scholarly journals Disappearing cervical disc

1996 ◽  
Vol 1 (6) ◽  
pp. E4 ◽  
Author(s):  
Richard M. Westmark ◽  
Kaye D. Westmark ◽  
Volker K. H. Sonntag
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Computerized Tomography ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Spontaneous Resolution ◽  
Herniated Disc ◽  
Cervical Disc ◽  
Resonance Imaging ◽  
Herniated Lumbar Disc

The authors report the case of a 48-year-old woman who experienced spontaneous resolution of a large herniated disc at C6-7. Spontaneous resolution of a herniated lumbar disc was first documented by computerized tomography. This case is another example of a rare spontaneous resolution of a cervical disc herniation documented by magnetic resonance imaging.

Anterior Lumbar Microdiscectomy and Interbody Fusion for the Treatment of Recurrent Disc Herniation

Neurosurgery ◽  
2001 ◽  
Vol 48 (2) ◽  
pp. 334-338 ◽  
Author(s):  
A. Giancarlo Vishteh ◽  
Curtis A. Dickman
Keyword(s):  
Interbody Fusion ◽  
Lumbar Disc ◽  
Posterior Longitudinal Ligament ◽  
Radicular Pain ◽  
Neurological Deficits ◽  
Herniated Disc ◽  
X Rays ◽  
Lumbar Microdiscectomy ◽  
Disc Herniations

Abstract OBJECTIVE To demonstrate the feasibility of anterior lumbar microdiscectomy in patients with recurrent, sequestered lumbar disc herniations. METHODS Between 1997 and 1999, six patients underwent a muscle-sparing “minilaparotomy” approach and subsequent microscopic anterior lumbar microdiscectomy and fragmentectomy for recurrent lumbar disc extrusions at L5–S1 (n = 4) or L4–L5 (n = 2). A contralateral distraction plug permitted ipsilateral discectomy under microscopic magnification. Effective resection of the extruded disc fragments was accomplished by opening the posterior longitudinal ligament. Interbody fusion was performed by placing cylindrical threaded titanium cages (n = 4) or threaded allograft bone dowels (n = 2). RESULTS There were no complications, and blood loss was minimal. Follow-up magnetic resonance imaging revealed complete resection of all herniated disc material. Plain x-rays revealed excellent interbody cage position. Radicular pain and neurological deficits resolved in all six patients (mean follow-up, 14 mo). CONCLUSION Anterior lumbar microdiscectomy with interbody fusion provides a viable alternative for the treatment of recurrent lumbar disc herniations. Recurrent herniated disc fragments can be removed completely under direct microscopic visualization, and interbody fusion can be performed in the same setting.

Unilateral surgical approach for lumbar disc herniation with contralateral symptoms

2012 ◽  
Vol 17 (2) ◽  
pp. 124-127 ◽  
Author(s):  
Taşkan Akdeniz ◽  
Tuncay Kaner ◽  
İbrahim Tutkan ◽  
Ali Fahir Ozer
Keyword(s):  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Surgical Approach ◽  
Lumbar Disc ◽  
Radicular Pain ◽  
Leg Pain ◽  
Motor Deficits ◽  
Disc Herniations ◽  
Herniated Lumbar Disc ◽  
Contralateral Symptoms

Object In most cases of lumbar disc herniation, the primary problem is usually limited to radicular pain due to nerve compression on the herniated side, which is generally limited to the side of operation. The aim of this study was to reevaluate the side of the surgical approach in a selected group of patients with leg pain and contralateral lumbar disc herniation. Methods Included in this study were a total of 5 patients with lumbar disc herniations who presented with contralateral symptoms and neurological signs. In all cases, patients underwent a microdiscectomy from the side ipsilateral to the herniated lumbar disc, the side contralateral to the motor deficits and leg pain. Results The symptoms and signs, to some extent, resolved during the immediate postoperative period. There were no postoperative complications. Conclusions The findings confirm that performing a laminotomy via the side of the herniation is sufficient for this group of patients.

Herniated lumbar disc disease in patients with malignancy.

1987 ◽  
Vol 5 (4) ◽  
pp. 667-671 ◽  
Author(s):  
R Goodkin ◽  
B I Carr ◽  
R G Perrin
Keyword(s):  
Spinal Metastasis ◽  
Lumbar Disc ◽  
Correct Diagnosis ◽  
Signs And Symptoms ◽  
Herniated Disc ◽  
Disc Disease ◽  
Lumbar Disc Disease ◽  
Delay In Diagnosis ◽  
Patients With Cancer ◽  
Herniated Lumbar Disc

Six patients with cancer presented with signs and symptoms of a lumbar herniated disc syndrome due to a herniated lumbar disc. The differential diagnosis and literature are reviewed. In four of the six, the patients' complaints were attributed to the malignancy, with delay in diagnosis and institution of appropriate therapy. In two of the patients, treatment was administered for presumed spinal metastasis with radiation therapy and/or chemotherapy with castration before the correct diagnosis was made. Surgery was performed on all six patients confirming the diagnosis of a herniated lumbar disc at the involved level and relieving the patients' pain.

Effect of trunk control training on plantar pressure in patients with lumbar disc herniation

2020 ◽  
Vol 27 (8) ◽  
pp. 1-12
Author(s):  
Hanan Hosny M Battesha ◽  
Reda Kotb Abd Elrazik Gad Elhak
Keyword(s):  
Physical Therapy ◽  
Lumbar Disc Herniation ◽  
Plantar Pressure ◽  
Lumbar Disc ◽  
Control Group ◽  
Study Group ◽  
Trunk Control ◽  
Herniated Lumbar Disc ◽  
The Right ◽  
Therapy Programme

Background/aims Chronic spinal disc disease leads to disorders in postural movement coordination. An incorrect asymmetrical movement pattern for lower limb loading impairs proprioception and deteriorates postural stability. The aim of this study was to investigate the effect of trunk control training on the redistribution of plantar pressure to reduce the risk of posture sway while standing in patients with sciatica resulting from a herniated lumbar disc. Methods This study included 30 male and female patients with sciatica resulting from lumbar disc herniation, their ages ranged from 45–60 years. The patients were randomly assigned to two equal groups. The study group received posture stability training by using the Biodex Balance System in addition to a selected physical therapy programme. The control group received the selected physical therapy programme only. Results: The results revealed that in the study group, there was a significant increase of plantar pressure at the right and the left centre of heel, while there was a significant decrease of plantar pressure at the right and the left forefoot post treatment. In the control group, there was no significant difference in plantar pressure at the right and the left centre of the heel and forefoot post treatment. Conclusions: Trunk control training, in addition to the selected physical therapy programme, was more effective than only using the selected physical therapy programme to redistribute foot plantar pressure, which can reduce posture sway for patients with sciatica resulting from a herniated lumbar disc.

Disappearing cervical disc

1997 ◽  
Vol 86 (2) ◽  
pp. 289-290 ◽  
Author(s):  
Richard M. Westmark ◽  
Kaye D. Westmark ◽  
Volker K. H. Sonntag
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Lumbar Disc ◽  
Spontaneous Resolution ◽  
Herniated Disc ◽  
Cervical Disc ◽  
Resonance Imaging ◽  
Content Type ◽  
Herniated Lumbar Disc ◽  
Fine Print

✓ The authors report the case of a 48-year-old woman who experienced spontaneous resolution of a large herniated disc at C6–7. Spontaneous resolution of a herniated lumbar disc was first documented by computerized tomography. This case is another example of a rare spontaneous resolution of a cervical disc herniation documented by magnetic resonance imaging.

scholarly journals Endoscopic Transforaminal Discectomy for an Extruded Lumbar Disc Herniation

2013 ◽  
Vol 1;16 (1;1) ◽  
pp. E31-E35
Author(s):  
Albert E. Telfeian
Keyword(s):  
Minimally Invasive ◽  
Vertebral Body ◽  
Lumbar Disc ◽  
Scar Tissue ◽  
Herniated Disc ◽  
Transforaminal Approach ◽  
Endoscopic Discectomy ◽  
Back Surgery ◽  
Herniated Lumbar Disc ◽  
Herniated Discs

Microsurgery for lumbar herniated discs that require surgical intervention is a very successful and well-described technique, whether performed through more traditional “open” microsurgical retractors or through minimally-invasive “tube” retractors. Surgery for extruded lumbar disc fragments that migrate caudad or cephalad from the disc origin may typically require modifying the standard hemilaminotomy by removing additional laminar bone to retrieve the migrated fragment. Although midline and paramedian Wiltse approaches have been the standard methods for resecting herniated lumbar disc fragments, advances in neuroendoscopic techniques have expanded the potential targets for transforaminal endoscopic treatment to include extruded lumbar disc fragments. Sequestrations migrated cephalad or caudal to the disc can be removed using specialized flexible instruments. The instruments enable the surgeon to circumnavigate and reach into the epidural space and as far as the mid-vertebral body. The authors present a case of an endscopically resected lumbar herniated disc fragment extruded caudad behind the inferior vertebral body through a transforaminal approach in an awake patient using local anesthetic. Radiographic and endoscopic visualization make it possible to access intracanal pathology. Although more traditional lumbar disc surgery is widely performed and is safe and effective, neuroendoscopic procedures may also allow a safe and effective approach for even extruded disc fragments for patients who cannot tolerate general anesthesia or are seeking the most minimally invasive option. Endoscopic discectomy is a minimally invasive alternative to open back surgery. Maintained spinal stability and absence or minimal formation of scar tissue allow for ease of subsequent surgeries, both open and minimally invasive (if needed). Key words: Endoscopic discectomy, minimally-invasive, transforaminal, TESSYS

Sign in / Sign up

Export Citation Format

Share Document