Facet syndrome. Minimally invasive surgical treatment. (Clinical case with a literature re-view).

The problem of the pathology of the facet joints of the lumbar spine remains significant and is medical and social due to persistent pain syndrome, high incidence of morbidity and frequent disability outcomes. The complex anatomical and topographic relationships of the facet joints, intervertebral discs and radicular nerves force clinicians to pay attention to the pathology of facet syndrome. A pair of facet joints and an intervertebral disc constitute a functional unit - a "three-component complex" and are interconnected with each other. The article examines the anatomical and morphological features and radiological classifications of degenerative changes in the facet joints, which are currently used in clinical practice. Facet joint pathologies are the most common nosological form of degenerative-dystrophic process (spondyloarthrosis) and a potential source of pain with the formation of instability of the spinal motion segment and the formation of chronic pain syndrome. The features of facet syndrome diagnostics are presented on a clinical example of surgical treatment by means of laser dereception of facet joints.

Download Full-text

Minimally invasive surgery for spine osteomyelitis treatment

Siberian medical review ◽

10.20333/2500136-2021-1-104-110 ◽

2021 ◽

pp. 104-110

Author(s):

Ye.Ya. Kochnev ◽

◽

S.Vl. Lyulin ◽

S.V. Mukhtyaev ◽

I.A. Meshcheryagina ◽

...

Keyword(s):

Minimally Invasive Surgery ◽

Surgical Treatment ◽

Minimally Invasive ◽

Invasive Surgery ◽

Surgical Intervention ◽

Life Quality ◽

Pain Syndrome ◽

Minimally Invasive Surgical ◽

Minimally Invasive Surgical Treatment

The aim of the research is to study the results of minimally invasive surgery for the treatment of nonspecifi c infectious spine lesions, and to present personal experience. Material and methods. Three patients with purulent nonspecifi c spondylodiscitis of lumbar spine got minimally invasive surgical treatment. The essence of surgical intervention included X-ray-assisted placement of tubular retractors in the area of intervertebral disc aff ected by purulent process; debridement and irrigation with antiseptic solution of interbody space, and setting a drain tube. All patients were treated during the period from December 2016 to February 2019. They were examined before surgery and in 3 months aft er the discharge. Laboratory parameters (CBT, C-reactive protein, bacteriological analysis of intervertebral disc contents) and instrumental research methods (computer tomography, magnetic resonance imaging) were evaluated. ODI, VAS, SF-36 questionnaires helped to assess pain syndrome and life quality of patients. Results. In 100 % of studied cases infection was caused by Staphylococcus aureus. The result of treatment in all cases was assessed as good, because pain syndrome, neurological disorders and inflammatory process were arrested; there were no signs of disease progression. In all cases, life quality of patients was restored. In one case, additional surgical intervention was required (posterior instrumental fi xation of spine) because of instability signs. Conclusion. Minimally invasive surgical treatment of purulent single-level spondylodiscites can be recommended for practical use. The use of such approache allows to verify purulent infection agent, to damage soft tissues less getting proper sanitation of interbody space. It also allows to stop the infection and restore life quality of a patient

Download Full-text

Minimally Invasive Surgical Treatment for GERD

Nihon Kikan Shokudoka Gakkai Kaiho ◽

10.2468/jbes.63.120 ◽

2012 ◽

Vol 63 (2) ◽

pp. 120-120

Author(s):

S. Ozawa

Keyword(s):

Surgical Treatment ◽

Minimally Invasive ◽

Minimally Invasive Surgical ◽

Minimally Invasive Surgical Treatment

Download Full-text

Regression of Enlarged Lumbar Zygapophyseal Inclusions after Manipulative Therapy

Rivista di Neuroradiologia ◽

10.1177/197140099801100115 ◽

1998 ◽

Vol 11 (1) ◽

pp. 113-116

Author(s):

V. Rucco ◽

P.-T. Basadonna ◽

D. Gasparini

Keyword(s):

Magnetic Resonance ◽

Magnetic Resonance Image ◽

Pain Syndrome ◽

Spontaneous Pain ◽

Low Back ◽

Facet Joints ◽

Manipulative Therapy ◽

Facet Syndrome ◽

Lumbar Facet

We describe a case of low back pain (LBP) secondary to a facet syndrome, with a magnetic resonance image of enlarged zygapophyseal inclusions, which both regressed with manipulative therapy. The role of the lumbar zygapophyseal inclusion in the pain syndrome remains uncertain, because there are no studies on these inclusions in the lumbar facet syndrome. The explanation of the role of manual therapy is also uncertain (adjusting joint subluxations, restoring bony alignment, reducing nuclear protrusion, reducing meniscoid entrapment or extrapment, decompressing facet joints, etc). The diagnosis of classical facet syndrome LBP was made by history-taking and physical examination. The diagnosis of intra-articular enlargements was made by magnetic resonance imaging. The manipulative therapy consisted of manipulations in rotation with the spine placed in kyphosis. Before every manipulation session, spontaneous pain, pain with pressure on the zygapophyseal joint and the range of thoracic and lumbar spine motions were evaluated. After the fourth manipulation session, the patient's pain was alleviated and the enlarged zygapophyseal inclusions were no longer visible. The clinical improvement continued at the controls one and two months after the end of the manipulative therapy. This is the first report of facet syndrome LBP with a magnetic resonance image of enlarged zygapophyseal inclusions which both regressed with manipulative therapy. It is interesting to speculate on the possible mechanisms to explain this outcome, but further studies are needed.

Download Full-text