scholarly journals Unexpected Combined Double Posterior and Anterior Approach to Treat Thoracic Disc Herniation: a Case Report

2021 ◽  
pp. 250
Author(s):  
Keyword(s):  
Case Report ◽  
Surgical Treatment ◽  
Magnetic Resonance ◽  
Medical Treatment ◽  
Disc Herniation ◽  
Anterior Approach ◽  
Magnetic Resonance Images ◽  
Neurologic Symptoms ◽  
Disc Herniations ◽  
Thoracic Disc

Introduction: Although frequently observed in magnetic resonance images, symptomatic thoracic disc herniations are rare. Surgical treatment is indicated when patients suffer from functional symptoms with no response to medical treatment, when neurologic symptoms appear or worsen or in the event of myelopathy. Posterolateral approaches are commonly accepted as the treatment for lateral and mediolateral disc herniations and non-calcified medial herniations. On the other hand, anterior approaches have been accepted to treat gigantic calcified medial disc herniations. Case presentation: This case report presents on a 57-year-old female patient suffering from thoracolumbar pain and impairment. The magnetic resonance study showed images compatible with a posteromedial T12-L1 disc herniation that, after medical treatment failure, required surgical treatment. Initially, a posterior approach was performed, resulting in the immediate postoperative period in motor and sensitive deficit of the lower left limb, so a surgical reintervention was performed using an anterior approach, obtaining good clinical and functional results. Conclusion: Thoracic disc herniations are uncommon. Surgical indication is decided in the presence of neurologic symptoms. Neurologic injury is a common complication due to the lesion’s characteristics and it can also be secondary to the surgical procedure. An adequate election of the surgical approach may minimize neurologic injuries.

scholarly journals Surgical treatment of thoracic disc herniation using the anterior approach

1982 ◽  
Vol 64-B (3) ◽  
pp. 340-343 ◽  
Author(s):  
K Otani ◽  
S Nakai ◽  
Y Fujimura ◽  
S Manzoku ◽  
K Shibasaki
Keyword(s):  
Surgical Treatment ◽  
Disc Herniation ◽  
Anterior Approach ◽  
Thoracic Disc Herniation ◽  
Thoracic Disc

scholarly journals ANALYSIS OF THE RELIABILITY OF THE LEE CLASSIFICATION FOR LUMBAR DISC HERNIATIONS

2020 ◽  
Vol 19 (4) ◽  
pp. 258-261
Author(s):  
LUAN CELSO GONÇALVES ◽  
ALBERTO OFENHEJM GOTFRYD ◽  
MARIA FERNANDA SILBER CAFFARO ◽  
NELSON ASTUR ◽  
RODRIGO GOES MEDÉA DE MENDONÇA ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Interobserver Reliability ◽  
Lumbar Disc ◽  
Cross Sectional Study ◽  
Magnetic Resonance Images ◽  
Level Of Evidence ◽  
Cross Sectional ◽  
Disc Herniations

ABSTRACT Objective To evaluate the intra- and interobserver reliability of the Lee et al. classification for migrated lumbar disc herniations. Methods In 2018, Ahn Y. et al. demonstrated the accuracy of this classification for radiologists. However, magnetic resonance images are often interpreted by orthopedists. Thus, a cross-sectional study was conducted by evaluating the magnetic resonance images of 82 patients diagnosed with lumbar disc herniation. The images were evaluated by 4 physicians, 3 of whom were spinal orthopedic specialists and 1 of whom was a radiologist. The intra- and interobserver analysis was conducted using the percentage of concordance and the Kappa method. Results The report of the classifications used by the four observers had a higher proportion of “zone 3” and “zone 4” type classifications in both evaluation moments. The most affected anatomical levels were L5-S1 (48.2%) and L4-L5 (41.4%). The intra- and interobserver concordance, when comparing both moments evaluation of the complementary examinations of the participants involved, was classified as moderate and very good. Conclusions Lee’s classification presented moderate to very good intra- and interobserver reliability for the evaluation of migrated lumbar disc herniation. Level of evidence II; Retrospective Study.

scholarly journals A Case Report of Volar Dislocation of Ulnar Head: A Very Rare Wrist Injury Easy to Overlook and Easy to Diagnose

2021 ◽  
Vol 11 (7) ◽  
Author(s):  
Ozcan Kaya ◽  
Okan Ozkunt ◽  
Irem Kurt
Keyword(s):  
Case Report ◽  
Magnetic Resonance ◽  
Physical Examination ◽  
Outpatient Service ◽  
Distal Radioulnar Joint ◽  
Magnetic Resonance Images ◽  
Wrist Pain ◽  
Wrist Injury ◽  
Forearm Rotation ◽  
Radioulnar Joint

Introduction: Ulnar volar dislocation (UVD) is a very rare entity. Due to rarity of condition, usually, it’s misdiagnosed at emergency departments and management of this clinical entity is not well studied. Here, we report a case of UVD impressing diagnostic challenge, indication of treatment, and follow-up. Case Report: A 29-year-old man presented to orthopedic outpatient service with complaining of the right wrist pain. He had an assault history 3 days before. In the emergency department, he had been diagnosed as wrist sprain. Splint and pain killers were prescribed. Due to increase of pain, he admitted to orthopedics. He was diagnosed UVD. Under general anesthesia, joint was reduced with forced pronation maneuver. After 3 weeks immobilization period, magnetic resonance images revealed partial injury of triangular fibrocartilage complex then splint removed and rehabilitation initiated. Over than 24 months, he is doing well without movement limitation and wrist strength impairment. Conclusion: For prevention misdiagnosis of UVD, physical examination is very important. Forearm rotation limitation with pain in the wrist should be indicative for distal radioulnar joint injury. Physical examination should be supported with proper evaluation of suitable radiographs. After reduction of joint, magnetic resonance images give clues about ligamentous injury. Our case supports the importance of rigorous physical examination and evaluation of radiographs for wrist injury. In the presence of partial injury of ligaments, the condition can be treated with shorter periods of immobilization and early rehabilitation. Keywords: Wrist pain, ulnar volar dislocation, distal radioulnar joint, forearm rotation.

scholarly journals Myelopathy associated with age-related cervical disc herniation: a retrospective review of magnetic resonance images

2017 ◽  
Vol 37 (2) ◽  
pp. 130-137 ◽  
Author(s):  
Nosaiba Tawfik Al-Ryalat ◽  
Saif Aldeen Saleh AlRyalat ◽  
Walid Sulaiman Mahafza ◽  
Osama Ahmad Samara ◽  
Abdee Tawfiq Ryalat ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Disc Herniation ◽  
Retrospective Review ◽  
Magnetic Resonance Images ◽  
Cervical Disc Herniation ◽  
Cervical Disc ◽  
Age Related

scholarly journals Sleep Apnea and Unilateral Upper and Lower Extremity Allodynia as a Result of a Large Thoracic Disc Herniation: A Case Report

2021 ◽  
Author(s):  
Tyler D. Alexander ◽  
Anthony Stefanelli ◽  
Sara Thalheimer ◽  
Joshua E. Heller
Keyword(s):  
Spinal Cord ◽  
Sleep Apnea ◽  
Sexual Dysfunction ◽  
Lower Extremity ◽  
Disc Herniation ◽  
Cord Compression ◽  
Thoracic Disc Herniation ◽  
Lower Extremity Weakness ◽  
Disc Herniations ◽  
Thoracic Disc

Abstract BackgroundClinically significant disc herniations in the thoracic spine are rare accounting for approximately 1% of all disc herniations. In patients with significant spinal cord compression, presenting symptoms typically include ambulatory dysfunction, lower extremity weakness, lower extremity sensory changes, as well as bowl, bladder, or sexual dysfunction. Thoracic disc herniations can also present with thoracic radiculopathy including midback pain and radiating pain wrapping around the chest or abdomen. The association between thoracic disc herniation with cord compression and sleep apnea is not well described.Case PresentationThe following is a case of a young male patient with high grade spinal cord compression at T7-8, as a result of a large thoracic disc herniation. The patient presented with complaints of upper and lower extremity unilateral allodynia and sleep apnea. Diagnosis was only made once the patient manifested more common symptoms of thoracic stenosis including left lower extremity weakness and sexual dysfunction. Following decompression and fusion the patient’s allodynia and sleep apnea quickly resolved.ConclusionsThoracic disc herniations can present atypically with sleep apnea – a symptom which may resolve with surgical treatment.

Thoracic Disc Herniation: 1 Case Report

1988 ◽  
Vol 23 (6) ◽  
pp. 1554
Author(s):  
Min Gi Kang ◽  
Jung Hwan Son ◽  
Jang Suk Choi ◽  
Young Goo Lee
Keyword(s):  
Case Report ◽  
Disc Herniation ◽  
Thoracic Disc Herniation ◽  
Thoracic Disc

scholarly journals Revision surgery in thoracic disc herniation

2019 ◽  
Vol 29 (S1) ◽  
pp. 39-46
Author(s):  
Stephan Dützmann ◽  
Roli Rose ◽  
Daniel Rosenthal
Keyword(s):  
Disc Herniation ◽  
Revision Surgery ◽  
Cord Compression ◽  
Thoracic Disc Herniation ◽  
Disc Disease ◽  
Neurological Improvement ◽  
Initial Symptoms ◽  
Disc Herniations ◽  
Clinical Records ◽  
Thoracic Disc

Abstract Purpose Surgical treatment failures or strategies for the reoperation of residual thoracic disc herniations are sparsely discussed. We investigated factors that led to incomplete disc removal and recommend reoperation strategies. Methods As a referral centre for thoracic disc disease, we reviewed retrospectively the clinical records and imaging studies before and after the treatment of patients who were sent to us for revision surgery for thoracic disc herniation from 2013 to 2018. Results A total of 456 patients were treated from 2013 to 2018 at our institution. Twenty-one patients had undergone previously thoracic discectomy at an outside facility and harboured residual, incompletely excised and symptomatic herniated thoracic discs. In 12 patients (57%), the initial symptoms that led to their primary operation were improved after the first surgery, but recurred after a mean of 2.8 years. In seven patients (33%) they remained stable, and in two cases they were worse. All patients were treated via all dorsal approaches. In all 21 cases, the initial excision was incomplete regarding medullar decompression. All of the discs were removed completely in a single revision procedure. After mean follow-up of 24 months (range 12–57 months), clinical neurological improvement was demonstrated in seven patients, while three patients suffered a worsening and 11 patients remained stable. Conclusion Our data suggest that pure dorsal decompression provides a short relief of the symptoms caused by spinal cord compression. Progressive myelopathy (probably due to mechanical and vascular deficits) and scar formation may cause worsening of symptoms. Graphic abstract These slides can be retrieved under Electronic Supplementary Material.

scholarly journals Diagnosis and Treatment of Patellar Tendon Gouty Tophus: A Case Report

2019 ◽  
Vol 05 (02) ◽  
pp. e46-e49 ◽  
Author(s):  
Theodoros Bouras ◽  
Maulik Gandhi ◽  
Andrew Barnett
Keyword(s):  
Case Report ◽  
Surgical Treatment ◽  
Medical Treatment ◽  
Patellar Tendon ◽  
Unusual Case ◽  
Arthroscopic Surgery ◽  
Diagnosis And Treatment ◽  
Viable Option ◽  
Gouty Tophus ◽  
Open Excision

AbstractThe main aim of this case report is to thoroughly describe the steps of diagnosis and treatment in the rare incidence of patellar tendon gouty tophus. The case of a 53-year-old man manual worker who was treated with open excision of the lesion, following failure of extended medical treatment with rheumatological input, is presented. Surgical treatment led to full restoration of the patient's knee function. Open or arthroscopic surgery is a viable option for the unusual case of intratendinous patellar gouty deposition if the patient fails medical management. Medical treatment should still be the mainstay.

Bizarre Parosteal Osteochondromatous Proliferation (Nora's Lesion) of the Sesamoid: a Case Report

2000 ◽  
Vol 21 (5) ◽  
pp. 408-412 ◽  
Author(s):  
J.A. Harty ◽  
P. Kelly ◽  
D. Niall ◽  
J.C. O'Keane ◽  
M.M. Stephens
Keyword(s):  
Case Report ◽  
Magnetic Resonance ◽  
Metatarsophalangeal Joint ◽  
Magnetic Resonance Images ◽  
Parosteal Osteosarcoma ◽  
Bizarre Parosteal Osteochondromatous Proliferation ◽  
First Metatarsophalangeal Joint ◽  
Histological Features ◽  
Nora’S Lesion ◽  
Plantar Aspect

We report the a case of Nora's lesion (Bizarre Parosteal Osteochondromatous Proliferation) of the sesamoid. A 32-year-old woman presented with a painless, enlarging mass of two years duration on the plantar aspect of the first metatarsophalangeal joint of the left foot. Radiographs, Computerized Tomographs and Magnetic Resonance images, initially suggested a parosteal osteosarcoma arising from the tibial sesamoid. The mass was excised, and a histological diagnosis of Bizarre Parosteal Osteochondromatous Proliferation of bone (Nora's lesion) was made. The aggressive growth of this lesion may suggest a neoplasm clinically. Histological features, however, are those of a reactive lesion.

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