Osteoporotic vertebral fracture misdiagnosed as “normal postoperative phenomenon” in post decompression surgery: a case report

Abstract Background Previous research and published literature indicate that some patients with spinal diseases who underwent percutaneous transforaminal endoscopic decompression (PTED) still suffer some discomfort in the early recovery stage in the form of pain, stiffness, and swelling. These are usually considered minor residual symptoms or normal postoperative phenomenon (NPF) in the clinic, occur frequently, and are acknowledged by surgeons worldwide. To the best of our knowledge, we report the first case of a patient who had an osteoporotic vertebral fracture (OVF) misdiagnosed as NPF after she underwent PTED as a result of lumbar disc herniation (LDH). Case presentation A 71-year-old female with Parkinson’s disease who presented with lower back pain radiating to the legs was diagnosed as LDH in L4–5, after which a PTED of L4–5 was performed, with temporary alleviation of symptoms. However, severe lower back pain recurred. Unfortunately, the recurred pain initially misdiagnosed as NPF, in fact, was finally confirmed to be OVF by CT-scan. OVF in the early stage of post-PTED seldom occurs and is rarely reported in the literature. With a percutaneous vertebroplasty, the pain was significantly relieved, and she resumed walking. After 36-weeks of follow-up, the pain improved satisfactorily. Conclusion Doctors should not immediately diagnose a relapse of back pain following PTED as NPF, and hands-on careful physical and imaging examinations are necessary to manage recurring pain rightly and timely.

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Spinal Intradural, Extramedullary Ependymoma with Astrocytoma Component: A Case Report and Review of the Literature

Case Reports in Pathology ◽

10.1155/2016/3534791 ◽

2016 ◽

Vol 2016 ◽

pp. 1-5 ◽

Cited By ~ 2

Author(s):

Gene M. Weinstein ◽

Knarik Arkun ◽

James Kryzanski ◽

Michael Lanfranchi ◽

Gaurav K. Gupta ◽

...

Keyword(s):

Back Pain ◽

Case Report ◽

Lower Back Pain ◽

Low Grade ◽

Review Of The Literature ◽

Pathologic Evaluation ◽

Lower Back ◽

Spinal Lesions ◽

First Case ◽

Intradural Extramedullary

Ependymomas are common spinal lesions, with the vast majority arising in an intramedullary location. Several cases have been described in the literature of ependymomas in an intradural, extramedullary location. The authors present a case of a 56-year-old female who presented with several weeks of lower back pain and weakness. MRI revealed an intradural, extramedullary enhancing mass at L1-L2. The mass was successfully resected surgically. Pathologic evaluation revealed a low grade glioma with components of both ependymoma and pilocytic astrocytoma with MUTYH G382D mutation. Extramedullary ependymomas are very rare tumors. To the authors’ knowledge, this is the first case of ependymoma/astrocytoma collision tumors described in an extramedullary location.

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Detecting Lower Back Pain Using Stacked Ensemble Approach

10.20944/preprints202007.0303.v1 ◽

2020 ◽

Author(s):

Samir Bandyopadhyay ◽

Shawni Dutta

Keyword(s):

Back Pain ◽

Lower Back Pain ◽

Early Stage ◽

Ensemble Classifier ◽

Experimental Result ◽

Counter Measures ◽

Lower Back ◽

Ensemble Machine Learning ◽

Absence From Work ◽

Previous Occupation

Lower Back Pain (LBP) is a disease that needs immediate attention. Person with back pain shall go immediately to doctor for treatment. Injury, excessive works and some medical conditions are result of back pain. Back pain is common to any age of human for different reasons. Due to factors such as previous occupation and degenerative disk disease the chance of developing lower back pain increases for older people. It hampers the working condition of people common reason for seeking medical treatment. The result is absence from work and is unable to normal due to pain. It creates uncomfortable and debilitating situations. Hence, detecting this disease at an early stage will assist the medical field experts to suggest counter measures to the patients. Detection of lower back pain is implemented in this paper by applying ensemble machine learning technique. This paper proposes Stacking ensemble classifier as an automated tool that will predict lower back pain tendency of a patient. Experimental result implies that the proposed method reaches an accuracy of 76.34%, f1-score of 0.76 and MSE of 0.34.

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How Decompression Surgery Improves the Lower Back Pain in Patient With Lumbar Degenerative Stenosis

Spine ◽

10.1097/brs.0000000000004265 ◽

2021 ◽

Vol Publish Ahead of Print ◽

Author(s):

Mitsuru Yagi ◽

Satoshi Suzuki ◽

Nori Satoshi ◽

Yohei Takahashi ◽

Osahiko Tsuji ◽

...

Keyword(s):

Back Pain ◽

Lower Back Pain ◽

Decompression Surgery ◽

Lower Back

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Minimally Invasive L5 Corpectomy with Navigated Expandable Vertebral Cage: A Technical Note

Brain Sciences ◽

10.3390/brainsci11091241 ◽

2021 ◽

Vol 11 (9) ◽

pp. 1241

Author(s):

Taro Yamauchi ◽

Ashish Jaiswal ◽

Masato Tanaka ◽

Yoshihiro Fujiwara ◽

Yoshiaki Oda ◽

...

Keyword(s):

Back Pain ◽

Minimally Invasive ◽

Lower Back Pain ◽

Revision Surgery ◽

Leg Pain ◽

Decompression Surgery ◽

Intraoperative Radiation ◽

Lower Back ◽

Estimated Blood Loss ◽

L5 Corpectomy

Background: Conventional L5 corpectomy requires a large incision and an extended period of intraoperative fluoroscopy. We describe herein a new L5 corpectomy technique. Methods: A 79-year-old woman was referred to our hospital for leg pain and lower back pain due to an L5 vertebral fracture. Her daily life had been affected by severe lower back pain and sciatica for more than 2 months. We initially performed simple decompression surgery, but this proved effective for only 10 months. Results: For revision surgery, the patient underwent minimally invasive L5 corpectomy with a navigated expandable cage without fluoroscopy. The second surgery took 215 min, and estimated blood loss was 750 mL. The revision surgery proved successful, and the patient could then walk using a cane. In terms of clinical outcomes, the Oswestry Disability Index improved from 66% to 24%, and the visual analog scale score for lower back pain improved from 84 to 31 mm at the 1-year follow-up. Conclusions: Minimally invasive L5 corpectomy with a navigated expandable vertebral cage is effective for reducing cage misplacement and surgical invasiveness. With this new technique, surgeons and operating room staff can avoid the risk of adverse events due to intraoperative radiation exposure.

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Transforaminal Epiduroscopic Laser Ablation for Removal of a Postlaminectomy Synovial Cyst: A Case Report

Medicina ◽

10.3390/medicina56050209 ◽

2020 ◽

Vol 56 (5) ◽

pp. 209

Author(s):

Hee Yong Kang ◽

So Yeon Kim ◽

Chung Hun Lee ◽

Sung Wook Park

Keyword(s):

Back Pain ◽

Case Report ◽

Lower Back Pain ◽

Nd:Yag Laser ◽

Rating Scale ◽

Synovial Cyst ◽

Pain Clinic ◽

Lower Back ◽

First Case ◽

Synovial Cysts

Background: Synovial cysts rarely occur after a laminectomy and are difficult to detect if there are no symptoms; however, they can cause lower back pain or symptoms of radiculopathy. Various methods are used to treat synovial cysts. Here, we will introduce the first case with treatment using the transforaminal epiduroscopic laser annuloplasty (TELA) system. Case report: A 64-year-old female patient visited the pain clinic with lower back pain and pain radiating from the left lower extremity. An MRI T2 image showed a synovial cyst of facet joint origin at the L4–L5 level; the patient had undergone a laminectomy 10 years ago at the same spinal level. The patient rated the pain an 8 on the numerical rating scale (NRS), and pain was reduced after epidural steroid injection, but symptoms recurred a month later. The cyst ablation was performed using the TELA system with a 1414 nm neodymium-doped yttrium-aluminum-garnet (Nd:YAG) laser, and after the procedure, pain decreased to 4 points immediately and was reduced to 2 points on the NRS after 1 week. Six months after the procedure, the pain level was measured on NRS 2 and cyst was not recurred in the additional MRI. Conclusion: We introduced the TELA system as a noninvasive therapy for treating synovial cysts. Ablation of cystic necks using a 1414 nm Nd:YAG laser could be a method to prevent cyst recurrence, but long-term follow-up and large scale control studies will be needed to verify the effectiveness of this method.

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Improvement of Lower Back Pain in Lumbar Spinal Stenosis After Decompression Surgery and Factors That Predict Residual Lower Back Pain

Global Spine Journal ◽

10.1177/2192568220905617 ◽

2020 ◽

pp. 219256822090561

Author(s):

Takahiro Kitagawa ◽

Yoji Ogura ◽

Yoshiomi Kobayashi ◽

Yoshiyuki Takahashi ◽

Yoshiro Yonezawa ◽

...

Keyword(s):

Back Pain ◽

Spinal Stenosis ◽

Lumbar Spinal Stenosis ◽

Lower Back Pain ◽

Decompression Surgery ◽

Thoracolumbar Kyphosis ◽

Lower Back ◽

Group I ◽

Lumbar Spinal

Study Design: Retrospective observational study. Objectives: There is no consensus to predict improvement of lower back pain (LBP) in lumbar spinal stenosis after decompression surgery. The aim of this study was to evaluate the improvement of LBP and analyze the preoperative predicting factors for residual LBP. Methods: We retrospectively reviewed 119 patients who underwent lumbar decompression surgery without fusion and had a minimum follow-up of 1 year. LBP was evaluated using the numerical rating scale (NRS), Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ) LBP score, and Roland-Morris Disability Questionnaire (RMDQ). All patients were divided into LBP improved group (group I) and LBP residual group (group R) according to the NRS score. Radiographic images were examined preoperatively and at the final follow-up. We evaluated spinopelvic radiological parameters and analyzed the differences between group I and group R. Results: LBP was significantly improved after decompression surgery (LBP NRS, 5.7 vs 2.6, P < .001; JOABPEQ LBP score, 41.3 vs 79.6, P < .001; RMDQ, 10.3 vs 3.6, P < .001). Of 119 patients, 94 patients were allocated to group I and 25 was allocated to group R. There was significant difference in preoperative thoracolumbar kyphosis between group I and group R. Conclusions: Most cases of LBP in lumbar spinal stenosis were improved after decompression surgery without fusion. Preoperative thoracolumbar kyphosis predicted residual LBP after decompression surgery.

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Injection of a Novel Biomimetic Aggrecan for the Restoration of Intervertebral Disc Tissue Mechanics

Volume 1B: Extremity; Fluid Mechanics; Gait; Growth, Remodeling, and Repair; Heart Valves; Injury Biomechanics; Mechanotransduction and Sub-Cellular Biophysics; MultiScale Biotransport; Muscle, Tendon and Ligament; Musculoskeletal Devices; Multiscale Mechanics; Thermal Medicine; Ocular Biomechanics; Pediatric Hemodynamics; Pericellular Phenomena; Tissue Mechanics; Biotransport Design and Devices; Spine; Stent Device Hemodynamics; Vascular Solid Mechanics; Student Paper and Design Competitions ◽

10.1115/sbc2013-14549 ◽

2013 ◽

Author(s):

Katsiaryna Prudnikova ◽

David Jamison ◽

Michele Marcolongo

Keyword(s):

Extracellular Matrix ◽

Back Pain ◽

Intervertebral Disc ◽

Disc Degeneration ◽

Lower Back Pain ◽

Mechanical Stability ◽

Early Stage ◽

Tissue Mechanics ◽

Lower Back ◽

Bottle Brush

Intervertebral disc degeneration and associated lower back pain is one of the leading musculoskeletal disorders confronting our health system with 15%–20% of the population experiencing lower back pain annually [1–4]. It has been shown that early in disc degeneration, the extracellular matrix of the nucleus pulposus is depleted of the proteoglycan aggrecan, resulting in loss of disc hydration, osmotic pressure and mechanical stability which leads to lower back pain [2, 5]. Early-stage restoration of the proteoglycan content within normal levels with natural aggrecan may help to restore disc functionality but it is cost prohibitive. We propose a new strategy to restore the extracellular matrix of the degenerated disc and mitigate lower back pain by molecularly engineering the disc matrix with an injection of a biomimetic aggrecan (BA) novel class of molecules that mimics the 3D bottle brush structure and physical properties of natural aggrecan.

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Lumbar Epidural Hematoma after Chiropractic Manipulation for Lower-Back Pain

Neurosurgery ◽

10.1227/01.neu.0000279740.61048.e2 ◽

2007 ◽

Vol 61 (1) ◽

pp. E170-E171 ◽

Cited By ~ 35

Author(s):

Ole Solheim ◽

Jan V. Jorgensen ◽

Oystein P. Nygaard

Keyword(s):

Back Pain ◽

Lower Back Pain ◽

Spinal Manipulation ◽

Epidural Hematoma ◽

Anticoagulation Therapy ◽

Cauda Equina ◽

Cervical Region ◽

Chiropractic Manipulation ◽

Lower Back ◽

First Case

Abstract OBJECTIVE Spinal manipulation therapy is widely used for the treatment of lower-back pain. Serious complications to spinal manipulation are most often seen in the cervical region. We report the first case of a lumbar epidural hematoma after chiropractic manipulation. CLINICAL PRESENTATION A 77-year-old man with a long history of lower-back pain underwent chiropractic manipulation of the lower spine. He was receiving anticoagulation therapy as a result of chronic atrial fibrillation. After a manipulation session, he developed partial cauda equina syndrome with lower extremity paresis and urinary retention. Computed tomographic and magnetic resonance imaging scans showed an epidural hematoma at the L3 level. INTERVENTION AND TECHNIQUE We performed surgical evacuation of the hematoma through laminectomy of L3 and L4. During the follow-up period, his motor deficits improved, but the bladder dysfunction remained. CONCLUSION This is the first case report of a lumbar epidural hematoma after chiropractic manipulation. Even rare complications after chiropractic manipulation of the spine should be weighed against potential benefits of such treatment. Caution should be shown in patients receiving antithrombotic therapy.

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