scholarly journals Classical open lumbar laminectomy and discectomy for disc herniations among manual labourers in India

2017 ◽  
Vol 5 (12) ◽  
pp. 5156
Author(s):  
Surendra Kumar Chellarapu ◽  
Satya Vara Prasad Kadali ◽  
Raja Sekhar B. ◽  
Raman B. V. S.
Keyword(s):  
Success Rate ◽  
Lumbar Disc ◽  
Gait Training ◽  
Herniated Disc ◽  
Canal Diameter ◽  
Adjacent Disc ◽  
Strenuous Work ◽  
Fibrotic Scar ◽  
Disc Herniations ◽  
History Of

Background: Lumbar disc herniations are most common at L4/5 and L5/S1 levels and this is most prevalent condition among manual laborers. The aim of the study to analyze the clinical presentation, age and sex distribution, immediate postoperative complications and long-term complications/recurrence of symptoms and to formulate recommendations to avoid complications and recurrence of symptoms.Methods: This is a retrospective study which includes 250 patients operated for lumbar disc herniations at L4/5 and L5/S1 levels. A detailed history of presenting complaints, clinical examination and corresponding findings on imaging are correlated. In all these patients, there was severe symptomatology with failed conservative management which necessitated classical open lumbar laminectomy and discectomy. These patients were followed for a period of 5 to 10 years.Results: Assessment of outcome was done using the modified Macnab criteria. The overall success rate was 96% in our series. Post operatively, 9.2% of them experienced localized low back pain which is mild to moderate and being treated with NSAIDS and exercises. 2.4% developed residual disc herniation or hypertrophic fibrotic scar at the operated site which needed surgical intervention. 2% developed spondylolysis and spondylolesthesis at the level of previous surgery, and 4.4% developed adjacent disc herniations.Conclusions: The overall success rate was 96% in our series. In addition to removal of herniated disc other compressing elements like hypertrophied Ligamentumflavum, facet arthropathy and narrowed spinal canal diameter are also addressed with open procedure. To prevent later complications, these patients are supposed to avoid strenuous work, lifting weights, torsion and jerky movements, faulty posture at work and rest, gait training, crouching, sitting on the floor and haunches.

scholarly journals Genotypic and Antimicrobial Characterisation ofPropionibacterium acnesIsolates from Surgically Excised Lumbar Disc Herniations

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Jess Rollason ◽  
Andrew McDowell ◽  
Hanne B. Albert ◽  
Emma Barnard ◽  
Tony Worthington ◽  
...  
Keyword(s):  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Herniated Disc ◽  
Type Ii ◽  
Type Ia ◽  
Disc Herniations ◽  
Typing Methods ◽  
Human Infections ◽  
Clinical Conditions

The anaerobic skin commensalPropionibacterium acnesis an underestimated cause of human infections and clinical conditions. Previous studies have suggested a role for the bacterium in lumbar disc herniation and infection. To further investigate this, five biopsy samples were surgically excised from each of 64 patients with lumbar disc herniation.P. acnesand other bacteria were detected by anaerobic culture, followed by biochemical and PCR-based identification. In total, 24/64 (38%) patients had evidence ofP. acnesin their excised herniated disc tissue. UsingrecAand mAb typing methods, 52% of the isolates were type II (50% of culture-positive patients), while type IA strains accounted for 28% of isolates (42% patients). Type III (11% isolates; 21% patients) and type IB strains (9% isolates; 17% patients) were detected less frequently. The MIC values for all isolates were lowest for amoxicillin, ciprofloxacin, erythromycin, rifampicin, tetracycline, and vancomycin (≤1mg/L). The MIC for fusidic acid was 1-2 mg/L. The MIC for trimethoprim and gentamicin was 2 to ≥4 mg/L. The demonstration that type II and III strains, which are not frequently recovered from skin, predominated within our isolate collection (63%) suggests that the role ofP. acnesin lumbar disc herniation should not be readily dismissed.

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.

scholarly journals Posterior epidural migration of a lumbar disc herniation

2020 ◽  
Vol 11 ◽  
pp. 4
Author(s):  
Meryem Himmiche ◽  
Khalid Chakour ◽  
Mohammed El Faiz Chaoui ◽  
Mohammed Benzagmout
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Cauda Equina Syndrome ◽  
Lumbar Disc ◽  
Cauda Equina ◽  
Low Back ◽  
Case Description ◽  
Disc Material ◽  
Disc Herniations ◽  
History Of

Background: Posterior epidural migration of a lumbar disc fragment (PEMLDF) refers to the dorsal migration of disc material around the thecal sac that can lead to radiculopathy and/or cause a cauda equina syndrome. It is rare and the diagnosis is often just established intraoperatively. Case Description: A 50-year-old male with a chronic history of low back pain and psychosis presented with PEMLDF originating at the L4–L5 level. Conclusion: Lumbar disc herniations rarely present as PEMLDF resulting in symptoms varying from radiculopathy to cauda equina syndrome. These should be included among the differential diagnostic considerations for dorsolateral epidural lesions.

scholarly journals Spontaneous Regression of Herniated Lumbar Disc with New Disc Protrusion in the Adjacent Level

2016 ◽  
Vol 2016 ◽  
pp. 1-4
Author(s):  
Tayfun Hakan ◽  
Serkan Gürcan
Keyword(s):  
Disc Herniation ◽  
Spontaneous Regression ◽  
Lumbar Disc ◽  
Bed Rest ◽  
Adjacent Level ◽  
Disc Protrusion ◽  
Left Lower Extremity ◽  
Disc Herniations ◽  
History Of ◽  
Herniated Lumbar Disc

Spontaneous regression of herniated lumbar discs was reported occasionally. The mechanisms proposed for regression of disc herniation are still incomplete. This paper describes and discusses a case of spontaneous regression of herniated lumbar discs with a new disc protrusion in the adjacent level. A 41-year-old man was admitted with radiating pain and numbness in the left lower extremity with a left posterolateral disc extrusion at L5-S1 level. He was admitted to hospital with low back pain due to disc herniation caudally immigrating at L4-5 level three years ago. He refused the surgical intervention that was offered and was treated conservatively at that time. He had no neurological deficit and a history of spontaneous regression of the extruded lumbar disc; so, a conservative therapy, including bed rest, physical therapy, nonsteroidal anti-inflammatory drugs, and analgesics, was advised. In conclusion, herniated lumbar disc fragments may regress spontaneously. Reports are prone to advise conservative treatment for extruded or sequestrated lumbar disc herniations. However, these patients should be followed up closely; new herniation at adjacent/different level may occur. Furthermore, it is important to know which herniated disk should be removed and which should be treated conservatively, because disc herniation may cause serious complications as muscle weakness and cauda equine syndrome.

scholarly journals Does Size Matter? An Analysis of the Effect of Lumbar Disc Herniation Size on the Success of Nonoperative Treatment

2019 ◽  
Vol 10 (7) ◽  
pp. 881-887 ◽  
Author(s):  
Anmol Gupta ◽  
Shivam Upadhyaya ◽  
Caleb M. Yeung ◽  
Peter J. Ostergaard ◽  
Harold A. Fogel ◽  
...  
Keyword(s):  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Conservative Management ◽  
Spinal Canal ◽  
Lumbar Disc ◽  
Nonoperative Treatment ◽  
Herniated Disc ◽  
Mri Scan ◽  
Cronbach's Alpha ◽  
Disc Herniations

Study Design: Retrospective study. Objective: In this study, we examined whether the size of a lumbar disc herniation (LDH) is predictive of the need for surgical intervention within 2 years after obtaining an initial magnetic resonance imaging (MRI) scan. We hypothesized that a fragment that occupied a larger percentage of the spinal canal would not predict which patients failed conservative management. Methods: Using the ICD-10 code M51.26, we identified patients at a single academic institution, across the 2-year period from 2015 to 2016, who received a diagnosis of primary lumbar radicular pain, had MRI showing a disc herniation, and underwent at least 6 weeks of nonoperative management. Patients experiencing symptoms suggesting cauda equina syndrome and those with progressive motor neurological deficits were excluded from analysis, as were patients exhibiting “hard” disc herniations. Within the axial view of an MRI, the following measurements were made on AGFA-IMPACS for a given disc herniation: the length of both the canal and the herniated disc along the anterior-posterior axis, the average width of the disc within the canal; the total canal area, and the area of the disc herniation. Data analysis was conducted in SPSS and a 2-tailed reliability analysis using Cronbach’s alpha as a measure of reliability was obtained. Results: A total of 368 patients met the inclusion and exclusion criteria for this study. Of these, 14 (3.8%) had L3-L4 herniations, 185 had L4-L5 herniations (50.3%), and 169 had L5-S1 herniations (45.9%). Overall, 336 (91.3%) patients did not undergo surgery within 1 year of the LDH diagnosis. Patients who did not receive surgery had an average herniation size that occupied 31.2% of the canal, whereas patients who received surgery had disc herniations that occupied 31.5% of the canal on average. A Cronbach’s alpha of .992 was observed overall across interobserver measurements. After controlling for age, race, gender, and location of herniation through a logistic regression, it was found that the size of the herniation and the percentage of the canal that was occupied had no predictive value with regard to failure of conservative management, generating an odds ratio for surgery of 1.00. Conclusions: The percentage of the spinal canal occupied by a herniated disc does not predict which patients will fail nonoperative treatment and require surgery within 2 years after undergoing a lumbar spine MRI scan.

Automated Percutaneous Discectomy: A Prospective Multi-Institutional Study

Neurosurgery ◽  
1990 ◽  
Vol 26 (2) ◽  
pp. 228-233 ◽  
Author(s):  
Gary Onik ◽  
Vert Mooney ◽  
Joseph C. Maroon ◽  
Leon Wiltse ◽  
Clyde Helms ◽  
...  
Keyword(s):  
Success Rate ◽  
Patient Selection ◽  
Lumbar Disc ◽  
Nerve Damage ◽  
Percutaneous Discectomy ◽  
Minimal Morbidity ◽  
Proper Patient Selection ◽  
Disc Herniations

Abstract A prospective multi-institutional study was carried out to evaluate automated percutaneous discectomy in the treatment of lumbar disc herniations. Of the 327 patients who prospectively met the study criteria and were followed for longer than 1 year, 75.2% were successfully treated. When patients (n = 168) who prospectively did not meet the study criteria were treated, the success rate was 49.4%. One case of discitis was reported; otherwise, no other serious complications were noted, and specifically no vascular or nerve damage was encountered. This study indicates that automated percutaneous discetomy can be used successfully to treat lumbar disc herniations with minimal morbidity and emphasizes the need for proper patient selection.

scholarly journals Extruded disc herniations are experienced earlier by inactive young people in the high-tech gaming era

2021 ◽  
Vol 14 (3) ◽  
pp. 402-407
Author(s):  
Demet Ucar ◽  
◽  
Sedat Duman ◽  
Yusuf Bayram ◽  
Bekir Yavuz Ucar ◽  
...  
Keyword(s):  
Young People ◽  
Lumbar Disc ◽  
Young Patients ◽  
Lifestyle Changes ◽  
Herniated Disc ◽  
Surgical Approaches ◽  
High Tech ◽  
Familial Predisposition ◽  
Disc Herniations ◽  
Disc Extrusion

In this study, we would like to draw attention to the advanced disc diseases seen in young people. The objective is to investigate the reasons for the increasing trend of disc herniations in young people. A total of 33 young patients with extruded lumbar disc herniations managed by conservative or surgical approaches between 2017 and 2018 were included. The average patient age was 25 years. Smoking, familial predisposition, sporting activity, and the occupation of the patients were questioned and noted. A visual analog scale (VAS) was used to assess the efficacy of pain. Body mass index (BMI) was calculated. All patients were subjected to lumbar magnetic resonance imaging. Eighteen patients (8 females, 10 males) had disc extrusion at the L5-S1 level, whereas 12 patients (8 females, 4 males) had disc extrusion at the L4-L5 level. Three other patients had disc extrusion at the level of both L4-L5 and L5-S1 levels. Motor deficits were detected in four patients, and surgical treatment was required and performed. The other 29 patients were treated conservatively. Young non-sport-oriented patients may face severe disc herniations. Understanding how spine degeneration can affect the likelihood of developing a herniated disc can help people make small lifestyle changes to postpone any serious pain and deficits. While aging is unavoidable, simple lifestyle changes can help improve overall spine health and deter the risk of developing a degenerative spine condition.

scholarly journals Lumbar disc herniation associated with scoliosis in a 15-year-old girl: case report

2002 ◽  
Vol 60 (2A) ◽  
pp. 295-298 ◽  
Author(s):  
Fernando Campos Gomes Pinto ◽  
Arthur W. Poetscher ◽  
Fausto Ricardo Erba Quinhones ◽  
Mário Pena ◽  
Mário Augusto Taricco
Keyword(s):  
Disc Herniation ◽  
Structural Changes ◽  
Lumbar Disc ◽  
Previous History ◽  
Young Patients ◽  
Rare Condition ◽  
Intervertebral Disc Herniation ◽  
Childhood And Adolescence ◽  
Disc Herniations ◽  
History Of

Intervertebral disc herniation is a rare condition in childhood and adolescence, although some cases have already been reported in the literature. We present the case of a 15 year-old-girl with low back pain and scoliosis. She had no previous history of trauma or collagen diseases. MRI showed L4-L5 and L5-S1 disc herniations and no further bone and structural changes. After two level discectomy, pain ceased and scoliosis improved, without further treatment. Based on her evolution and on what has already been reported in literature, we consider that scoliosis associated with disc herniation in young patients is most likely to be only an anthalgic position, not indicative of further structural changes.

scholarly journals Lumbar disc disease: the natural history

2002 ◽  
Vol 13 (2) ◽  
pp. 1-4 ◽  
Author(s):  
Nevan G. Baldwin
Keyword(s):  
Natural History ◽  
Lumbar Disc ◽  
Disease Process ◽  
Disc Disease ◽  
Lumbar Disc Disease ◽  
Discogenic Low Back Pain ◽  
Disc Herniations ◽  
History Of ◽  
The Impact ◽  
Better Than

Symptomatic lumbar disc disease represents a major cost to societies providing modern care for these conditions. The impact of any treatment cannot be assessed without an understanding of the natural history of the disease process. The majority of individuals with degenerative disc disease are asymptomatic. Although the natural history of sciatica is associated with a good overall prognosis, that of discogenic low-back pain is less promising. For patients with symptomatic lumbar disc herniations, the results of discectomy are better than those predicted by the natural history of the disease process.

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