The Lumbar Shield

Neurosurgery ◽  
1978 ◽  
Vol 3 (1) ◽  
pp. 26-36 ◽  
Author(s):  
James Rodney Feild ◽  
Hugh McHenry
Keyword(s):  
Intervertebral Disc ◽  
Disc Herniation ◽  
Nerve Root ◽  
Lumbar Disc ◽  
Operative Procedure ◽  
Gelatin Sponge ◽  
Lumbar Intervertebral Disc ◽  
Recurrent Disc Herniation ◽  
Lumbar Nerve Root ◽  
Cause Of Failure

Abstract Postoperative perineural adhesions between the lumbar nerve root and the partially removed intervertebral disc are thought to be a cause of failure of the standard operative procedure for the removal of a ruptured lumbar intervertebral disc. Attempts have been made to reduce postoperative perineural adhesions by the use of epidural muscle, fat, gelatin sponge, silicone, and steroids. The present communication introduces a new implantable silicone device, a lumbar shield. designed to: (a) provide a radiopaque marker on the dorsal perimeter of the excavated lumbar disc so that the presence or absence of a recurrent disc herniation can easily be determined on plain postoperative x-ray films, (b) provide ready access to the operative site in the event of a recurrent disc herniation. (c) prevent postoperative perineural adhesions between the lumbar dura and the nerve root and the partially removed intervertebral disc, and (d) prevent postoperative adhesions between the lumbar dura and the nerve root and the paraspinal muscles. Satisfactory results of lumbar disc surgery over the past 44 years have occurred in about 90% of routine patients. The value of the lumbar shield in 82 patients (59 routine and 23 workmen's compensation/medicolegal patients) followed for 6 months is described. A satisfactory result, i.e., relief of pain or the presence of occasional postoperative pain, occurred in 85% of routine patients at 1 month, 97% at 3 months. and 95% at 6 months.

Evaluation of the post-operative lumbar spine with MR imaging

1997 ◽  
Vol 38 (6) ◽  
pp. 1035-1042 ◽  
Author(s):  
P. Grane ◽  
M. Lindqvist
Keyword(s):  
Lumbar Spine ◽  
Contrast Enhancement ◽  
Disc Herniation ◽  
Nerve Root ◽  
Clinical Symptoms ◽  
Lumbar Disc ◽  
Nerve Roots ◽  
Contrast Administration ◽  
Repeat Surgery ◽  
Lumbar Nerve Root

Purpose: Two new signs of lumbar nerve-root affection have been reported in recent years on the basis of MR examinations, namely: thickening in nerve roots; and contrast enhancement in nerve roots. the aim of this study was to assess contrast enhancement in nerve roots in a standardised way, and to evaluate the clinical significance of contrast enhancement and of nerve-root thickening in the symptomatic post-operative lumbar spine Material and Methods: A total of 121 patients (who had previously been operated on for lumbar disc herniation) underwent 152 MR examinations, mainly on a 1.5 T system. Focal nerve-root enhancement was identified by visual assessment. Intradural enhancement was also quantified by pixel measurements that compared the affected nerve roots before and after contrast administration. Non-affected nerve roots were used as reference Results: Enhanced nerve roots in the dural sac increased at least 40–50% in signal intensity after contrast administration compared to pre-contrast images and also compared to non-affected nerve roots. Intradural nerve-root enhancement was seen in 10% of the patients and focal enhancement in the root sleeve was seen in a further 26%. Nerve-root thickening was seen in 30%. Good correlation with clinical symptoms was found in 59% of the patients with intradural enhancement, in 84% with focal enhancement, and in 86% with nerve-root thickening. the combination of thickening and enhancement in the nerve root correlated with symptoms in 86% of the patients Conclusion: Nerve-root enhancement (whether focal or intradural) and thickening in the nerve root are significant MR findings in the post-operative lumbar spine. in combination with disc herniation or nerve-root displacement, these two signs may strengthen the indication for repeat surgery. However, root enhancement within 6 months of previous surgery may be a normal post-operative finding

The femoral stretching test

1982 ◽  
Vol 57 (6) ◽  
pp. 813-817 ◽  
Author(s):  
M. N. Estridge ◽  
Stanley A. Rouhe ◽  
Neil G. Johnson
Keyword(s):  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Nerve Root ◽  
Lumbar Disc ◽  
Nerve Root Compression ◽  
Content Type ◽  
Lumbar Nerve Root ◽  
Upper Lumbar Disc Herniation ◽  
Fine Print

✓ The femoral stretching test is a valuable sign in diagnosing upper lumbar nerve root compression. We believe that it has the same significance for upper lumbar disc herniation as the sciatic stretching test has for the lower.

scholarly journals The Clinical Diagnostic Value of Lumbar Intervertebral Disc Herniation Based on MRI Images

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Kangxing Zheng ◽  
Zihuan Wen ◽  
Dehuai Li
Keyword(s):  
Intervertebral Disc ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Facet Joint ◽  
Lumbar Disc ◽  
Herniated Disc ◽  
Intervertebral Disc Herniation ◽  
Facet Joints ◽  
Lumbar Intervertebral Disc ◽  
Lumbar Intervertebral Disc Herniation

MRI was used to measure the changes in the angle of the facet joints of the lumbar spine and analyze the relationship between it and the herniated lumbar intervertebral disc. Analysis of the causes of lumbar disc herniation from the anatomy and morphology of the spine provides a basis for the early diagnosis and prevention of lumbar disc herniation. There is a certain correlation between the changes shown in MRI imaging of lumbar disc herniation and the TCM syndromes of lumbar intervertebral disc herniation. There is a correlation between the syndromes of lumbar disc herniation and the direct signs of MRI: pathological type, herniated position, and degree of herniation. Indirect signs with MR, nerve root compression and dural sac compression, are related. The MRI examination results can help syndrome differentiation to improve its accuracy to a certain extent. MRI has high sensitivity for the measurement of the angle of the facet joints of the lumbar spine and can be used to study the correlation between the changes of the facet joint angles and the herniated disc. Facet joint asymmetry is closely related to lateral lumbar disc herniation, which may be one of its pathogenesis factors. The herniated intervertebral disc is mostly on the sagittal side of the facet joint, and the facet joint angle on the side of the herniated disc is more sagittal. The asymmetry of the facet joints is not related to the central lumbar disc herniation, and the angle of the facet joints on both sides of the central lumbar disc herniation is partial sagittal.

Monoradiculopathy of the Fifth Lumbar Nerve Root Due to Lumbar Disc Herniation Between Lumbar One and Lumbar Two Vertebrae

1998 ◽  
Vol 11 (4) ◽  
pp. 350???353 ◽  
Author(s):  
Panagiotis Korovessis ◽  
Andreas Baikousis ◽  
Marios Stamatakis ◽  
Pavlos Katonis
Keyword(s):  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Nerve Root ◽  
Lumbar Disc ◽  
Lumbar Nerve Root

scholarly journals Clinical Study of Radiofrequency Ozone and Injection of Anti-inflammatory Analgesic Solution into the Internal Orifice of Nerve Root Combined with Traditional Chinese Medicine Hook Operation in the Treatment of Lumbar Disc Herniation

2021 ◽  
Author(s):  
WanHai Zhang ◽  
ZhiGang Wang ◽  
JianWei Yin ◽  
YuanYuan Bai ◽  
FengChao Qiu ◽  
...  
Keyword(s):  
Chinese Medicine ◽  
Treatment Group ◽  
Traditional Chinese Medicine ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Nerve Root ◽  
Lumbar Disc ◽  
Control Group ◽  
Lumbar Intervertebral Disc ◽  
Anti Inflammatory

Abstract Background: This study aims to explore the clinical efficacy of radiofrequency ozone and injection of anti-inflammatory analgesic solution into the internal orifice of nerve root combined with traditional Chinese medicine hook operation in the treatment of lumbar disc herniation. Methods: The patients with lumbar disc herniation in our hospital from December 20, 2017 to June 19, 2019 were selected as the main research subjects, and the patients were numbered according to the order of their first visits, and the included patients were divided into treatment group and control group using random number table method. Patients in the treatment group were treated with radiofrequency ozone and injection of anti-inflammatory analgesic solution into the internal orifice of nerve root combined with traditional Chinese medicine hook operation. Patients in the control group were treated with traditional lumbar intervertebral disc radiofrequency treatment. The clinical treatment effects of the two groups were observed. Results: A total of 113 patients were included in this study, of which 73 were in the treatment group and 40 were in the control group. The results of the study showed that the NRS scores of patients in the treatment group before treatment were 5±1.68 points, and the NRS scores were 2±0.78 points, 1±0.54 points, and 1±0.77 points 1 month, 3 months, and 1 year after treatment, respectively. The NRS scores of patients in the control group were 3±0.48 points, 2±0.63 points, and 2±0.85 points 1 month, 3 months, and 1 year after treatment. Compared with before treatment and the control group, there were significant differences (P<0.01). Conclusion: Compared with single lumbar intervertebral disc radiofrequency treatment, radiofrequency ozone and injection of anti-inflammatory analgesic solution into the internal orifice of nerve root combined with hook operation can obtain good short-term and medium-term effects in the treatment of lumbar disc herniation. It is a safe and effective minimally invasive treatment method.

scholarly journals Microendoscopic discectomy for recurrent disc herniations

2003 ◽  
Vol 15 (3) ◽  
pp. 1-4 ◽  
Author(s):  
Robert E. Isaacs ◽  
Vinod Podichetty ◽  
Richard G. Fessler
Keyword(s):  
Disc Herniation ◽  
Nerve Root ◽  
Lumbar Disc ◽  
Cerebrospinal Fluid Leak ◽  
Open Approach ◽  
Recurrent Disc Herniation ◽  
Previous Operation ◽  
Endoscopic Discectomy ◽  
Disc Herniations ◽  
Microendoscopic Discectomy

Object The use of microendoscopic discectomy (MED) for the treatment of primary lumbar disc herniations has become fairly well accepted; its role in recurrent disc herniations is less clear. The reluctance of many surgeons to use this technique stems, in part, from the concern of undertaking an endoscopic discectomy in a patient in whom the anatomy is distorted from a previous operation. It appears counterintuitive to operate through a limited working area when the traditional open approach for recurrence favors wider exposure of the surgical field. Given that operating on previously exposed tissue can be associated with even greater morbidity than on virginal tissue, the authors describe their experience with performing MED for recurrent disc herniation. Methods Unilateral MED was performed in patients with classic symptoms of lumbar radiculopathy, a previous operation at that level, and findings of recurrent disc herniation on magnetic resonance imaging. The approach was similar to a standard MED. Aided by fluoroscopic guidance, a working cannula was docked on the laminofacet junction at the level of the nerve root, with care taken to ensure a slightly more lateral initial trajectory. A good decompression of the nerve root could then be achieved through the use of the endoscope with preservation of the paraspinous musculature and much of the remaining facet capsule. Ten consecutive patients undergoing the procedure were analyzed prospectively and compared with the previous 25 who underwent routine single-level MED. Use of the MED technique provided excellent visualization and decompression of the nerve root; no conversions to open procedures were necessary in either group. The average operative time in the experimental group was 98.5 minutes, with a mean blood loss of 33 ml and an approximate hospital stay of 7.3 hours. In this respect, there was no statistical difference between the two groups (analysis of variance, p = 0.39, 0.68, and 0.51, respectively). There was one cerebrospinal fluid leak in each group. Conclusions Microendoscopic discectomy for recurrent disc herniation can be safely performed without an increase in surgery related morbidity.

scholarly journals THE EFFECTS OF ELECTRICAL ACUPUNCTURE AT LUMBAR NERVE ROOT FOR RADICULAR SCIATICA DUE TO LUMBAR DISC HERNIATION

2006 ◽  
Vol 55 (Supplement) ◽  
pp. S169-S172 ◽  
Author(s):  
MOTOHIRO INOUE ◽  
TATSUYA HOJO ◽  
MEGUMI ITOI ◽  
HIROSHI KITAKOJI ◽  
TADASHI YANO ◽  
...  
Keyword(s):  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Nerve Root ◽  
Lumbar Disc ◽  
Lumbar Nerve Root ◽  
Electrical Acupuncture

scholarly journals Effectiveness of Disc Excision in the Treatment of Herniated Lumbar Intervertebral Disc

2017 ◽  
Vol 3 (2) ◽  
pp. 37-42
Author(s):  
Sohail Amir ◽  
Maimoona Qadir ◽  
Muhammad Usman
Keyword(s):  
Pain Relief ◽  
Clinical Outcome ◽  
Intervertebral Disc ◽  
Effective Treatment ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Case Series ◽  
Sampling Technique ◽  
Lumbar Intervertebral Disc

OBJECTIVETo determine the efficacy of disc excision in the treatment of herniated lumbar intervertebral disc.METHODOLOGYThis study was conducted at Neurosurgery Department of Naseer Teaching Hospital, Peshawar from February 2015 to January 2016.The study design was descriptive case series in which consecutive non probability sampling technique was used. Clinical outcome of patients undergoing discectomy was determined using Stauffer-Coventry criteria and patients rated as excellent, good, fair and poorRESULTA total of 88 patients were recruited with 64% males and 36% females. Mean age was 39 years+4.68 SD.70% patients had L4-L5 and 30% had L5-S1 level disc herniation. Laminectomy was performed in 58%,fenestration in 34% and hemilaminectomy in 8% patients. Postoperatively at four weeks, satisfactory pain relief reported by 85% and unsatisfactory pain relief reported by 15% patients.CONCLUSIONConventional laminactomy, fenestration or hemilaminectomy is a feasible, safe and effective treatment in patients with lumbar disc herniation. Relief of pain is faster for patients assigned to early surgery.

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