scholarly journals Cervical disc herniation presenting with neck pain and contralateral symptoms: a case report

2012 ◽  
Vol 6 (1) ◽  
Author(s):  
Jacky T. Yeung ◽  
John I. Johnson ◽  
Aftab S. Karim
Keyword(s):  
Case Report ◽  
Neck Pain ◽  
Disc Herniation ◽  
Cervical Disc Herniation ◽  
Cervical Disc ◽  
Contralateral Symptoms

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

2014 ◽  
Vol 0 (0) ◽  
Author(s):  
Ahmet Aslan ◽  
Ünal Kurtoğlu ◽  
Mustafa Özgür Akça ◽  
Sinan Tan ◽  
Uğur Soylu ◽  
...  
Keyword(s):  
Case Report ◽  
Disc Herniation ◽  
Epidural Abscess ◽  
Cervical Disc Herniation ◽  
Cervical Disc

Cervical disc herniation: Is the regression flawed by age? A case report

2013 ◽  
Vol 20 (12) ◽  
pp. 612-616 ◽  
Author(s):  
Emanuele Di Ciaccio ◽  
Massimiliano Polastri ◽  
Alessandro Gasbarrini
Keyword(s):  
Case Report ◽  
Disc Herniation ◽  
Cervical Disc Herniation ◽  
Cervical Disc

Cervical Interlaminar Epidural Injections In The Treatment Of Cervical Disc Herniation, Post Surgery Syndrome, Or Discogenic Pain: Cost Utility Analysis From Randomized Trials

2019 ◽  
Vol 5 (22;5) ◽  
pp. 421-431
Author(s):  
Laxmaiah Manchikanti
Keyword(s):  
Neck Pain ◽  
Disc Herniation ◽  
Cost Utility ◽  
Cost Utility Analysis ◽  
Cervical Disc Herniation ◽  
Cervical Disc ◽  
Utility Analysis ◽  
Discogenic Pain ◽  
Epidural Injections ◽  
Post Surgery

Background: Neck pain is one of the major conditions attributing to overall disability in the United States. There have been multiple publications assessing clinical and cost effectiveness of multiple modalities of interventions in managing chronic neck pain. Even then, the literature has been considered sparse in relation to cervical interlaminar epidural injections in managing chronic neck pain. In contrast, cost utility studies of lumbar interlaminar injections, caudal epidural injections, cervical and lumbar facet joint nerve blocks, percutaneous adhesiolysis demonstrated costs of less than $3,500 for quality-adjusted life year (QALY). Objectives: To assess the cost utility of cervical interlaminar epidural injections in managing chronic neck and/or upper extremity pain secondary to cervical disc herniation, post-surgery syndrome in neck, and axial or discogenic neck pain. Study Design: Analysis based on 3 previously published randomized trials of the effectiveness of cervical interlaminar epidural injections assessing their role in disc herniation, cervical post-surgery syndrome, and axial or discogenic pain. Setting: A contemporary, private, specialty referral interventional pain management center in the United States. Methods: Cost utility of cervical interlaminar epidural injections with or without steroids in managing cervical disc herniation, cervical post-surgery syndrome, and cervical discogenic or axial neck back pain was conducted with data derived from 3 randomized controlled trials (RCTs) that included a 2-year follow-up, with inclusion of 356 patients. The primary outcome was significant improvement defined as at least 50% in pain reduction and disability status. Direct payment data from all carriers from 2018 was utilized for the assessment of procedural costs. Overall costs, including drug costs, were determined by multiplication of direct procedural payment data by a factor of 1.67 to accommodate for indirect payments respectively for disc herniation, discogenic pain, and cervical post-surgery syndrome. Results: The results of the 3 RCTs showed direct cost utility for one year of QALY of $2,412.31 for axial or discogenic pain without disc herniation, $2,081.07 for disc herniation, and $2,309.20 for post surgery syndrome, with an average cost per one year QALY of $2,267.57, with total estimated overall costs with addition of indirect costs of $3,475.38, $4,028.55, $3,856.36, and $3,785.89 respectively. Limitations: The limitation of this cost utility analysis includes that it is a single center evaluation. Indirect costs were extrapolated. Conclusion: This cost utility analysis of cervical interlaminar epidural injections in patients nonresponsive to conservative management in the treatment of disc herniation, post surgery syndrome and axial or discogenic neck pain shows $2,267.57 for direct costs with a total cost of $3,785.89 per QALY. Key words: Cervical interlaminar epidural injections, chronic neck pain, cervical disc herniation, cervical discogenic pain, post surgery syndrome, cost utility analysis, cost effectiveness analysis, quality-adjusted life years

scholarly journals Paraplegia after Gastrectomy in a Patient with Cervical Disc Herniation: A Case Report and Review of Literature

2014 ◽  
Vol 2014 ◽  
pp. 1-4
Author(s):  
Qingfu Zhang ◽  
Wei Jiang ◽  
Quanhong Zhou ◽  
Guangyan Wang ◽  
Linlin Zhao
Keyword(s):  
Spinal Cord ◽  
Case Report ◽  
Postoperative Complication ◽  
Disc Herniation ◽  
Surgical Decompression ◽  
Cervical Disc Herniation ◽  
Cervical Disc ◽  
Review Of Literature ◽  
History Of ◽  
Acute Paraplegia

Paraplegia is a rare postoperative complication. We present a case of acute paraplegia after elective gastrectomy surgery because of cervical disc herniation. The 73-year-old man has the medical history of cervical spondylitis with only symptom of temporary pain in neck and shoulder. Although the patient’s neck was cautiously preserved by using the Discopo, an acute paraplegia emerged at about 10 hours after the operation. Severe compression of the spinal cord by herniation of the C4-C5 cervical disc was diagnosed and emergency surgical decompression was performed immediately. Unfortunately the patient showed limited improvement in neurologic deficits even after 11 months.

scholarly journals Early surgical correction of cervical disc herniation might avoid complications associated with opioid-based pain management: A case report

2019 ◽  
Vol 10 ◽  
pp. 69 ◽  
Author(s):  
Ramsis Ghaly ◽  
Ana Pleasca ◽  
Kenneth D. Candido ◽  
Nebojsa Nick Knezevic
Keyword(s):  
Chronic Pain ◽  
Case Report ◽  
Pain Management ◽  
Disc Herniation ◽  
Life Support ◽  
Hospital Admissions ◽  
Surgical Intervention ◽  
Surgical Correction ◽  
Cervical Disc Herniation ◽  
Cervical Disc

Background: Opioids are considered an effective method for acute and chronic pain management, but they are not suitable for all cases and should be used in carefully selected patients. In the past several decades, their use has come under intense scrutiny due to significant deviations from the classically described applicability of opioids in cancer-related pain. Case Description: A 34-year-old female with a 6-year history of worsening neck pain and suboccipital headaches was managed medically including the use of oral muscle relaxants, steroids, gabapentin, and opioid-based medications as well as interventional pain procedures that provided only temporary pain relief. She made repeated ER visits and had multiple hospital admissions for pain control, during which times she was placed on patient-controlled analgesia with IV hydromorphone administration. During the most recent admission for an acute exacerbation of chronic pain, she was found by her mother to be unresponsive and not breathing. A code blue was called and cardiopulmonary resuscitation per an advanced cardiac life support algorithm was conducted. The patient was successfully resuscitated and was discharged from the hospital in satisfactory condition. This incident was reported as an “allergic reaction” to hydromorphone. After consultation with a neurosurgeon, the patient underwent a definitive surgical intervention consisting of a C5–6 anterior cervical discectomy and fusion using an interbody spacer and anterior instrumentation. Within 6 weeks, she reported significant decreases in her pain, stopped using the pain medication, and was able to return to her normal lifestyle. Conclusions: The present case report is an example of long-term pain management with multiple medications, including opioid use and performing interventional pain procedures, while avoiding early surgical correction of cervical disc herniation. This resulted in years of suffering with pain and serious morbidity from opioid overdosing. Surgical intervention was definitive in terms of ultimately improving her pain and reducing her reliance on opioid analgesics.

scholarly journals Analysis of compliance and efficacy of integrated management of whole process in the choice of percutaneous full-endoscopic surgery for patients with cervical disc herniation

2020 ◽  
Author(s):  
Zhongyan Jiang ◽  
Ansu Wang ◽  
Chong Wang ◽  
Weijun Kong
Keyword(s):  
Neck Pain ◽  
Recurrence Rate ◽  
Disc Herniation ◽  
Integrated Management ◽  
Cervical Disc Herniation ◽  
Cervical Disc ◽  
Control Group ◽  
Efficacy Rate ◽  
The Difference ◽  
Experimental Group

Abstract Background: Percutaneous spinal endoscopy is a new type of surgery for the treatment of cervical disc herniation. It can avoid the complications of the classic anterior cervical discectomy and fusion (ACDF) approach and the risk of adjacent spondylosis. How can we effectively improve patients' awareness of spinal endoscopy and their election of endoscopic techniques?Objective: To analyze the compliance and clinical effect of the integrated management of the whole process in the choice of percutaneous full-endoscopic surgery for patients with cervical disc herniation.Methods: Retrospective analysis of 72 patients with cervical disc herniation undergoing surgery in our hospital from August 2015–August 2017 was performed. The whole-process integrated management model was used for all the patients. The 36 patients in the experimental group were treated by percutaneous full-endoscopic cervical discectomy, and the 36 patients in the control group were treated by ACDF. The postoperative feeding time, time to get out of bed, length of hospital stay, compliance, clinical efficacy, and recurrence rate of neck pain were observed. Changes between the preoperative and postoperative pain visual analog scale (VAS) scores and neurological function Japan Orthopaedic Association (JOA) scores were assessed.Results: The postoperative feeding time in the experimental group was 8.319 ± 1.374 hours, the postoperative time to get out of bed was 16.64 ± 3.728 hours, and the hospitalization time was 6.403 ± 0.735 days. The excellent and good clinical efficacy rate was 91.67%, the compliance rate was 88.89%, and the neck pain recurrence rate was 5.56%. The postoperative feeding time in the control group was 26.56 ± 9.512 hours, the postoperative time to get out of bed was 45.06 ± 9.027 hours, and the length of hospital stay was 8.208 ± 0.865 days. The excellent and good clinical efficacy rate was 88.89%, the compliance rate was 69.4%, and the neck pain recurrence rate was 8.33%. There was no significant difference between the two groups in the excellent efficacy rate and the neck pain recurrence rate, p>0.05. The compliance rate in the experimental group was better than that in the control group, and the difference was statistically significant, p<0.05. The hospitalization time of the experimental group was significantly lower than that of the control group, and the difference was statistically significant, p<0.05. The postoperative VAS scores and JOA scores of the two groups were significantly better than the preoperative scores, and the difference was statistically significant, p<0.05; there was no significant difference between the two groups, p>0.05.Conclusion: The integrated management of the whole course can effectively improve the compliance of patients with cervical disc herniation receiving endoscopic treatment, yield the same treatment effect as the classic operation, shorten the hospitalization time, speed up the turnover of hospital beds, and improve satisfaction with medical quality and is worthy of clinical application.

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