scholarly journals Use of an Internal Retractor for Percutaneous Full-Endoscopic Resection in Cervical Intervertebral Disc Herniation with a Posterior Approach

2020 ◽  
Vol 14 (4) ◽  
pp. 489-494
Author(s):  
Shu Nakamura ◽  
Mitsuto Taguchi
Keyword(s):  
Intervertebral Disc ◽  
Nerve Root ◽  
Spinal Canal ◽  
Posterior Approach ◽  
Case Series ◽  
Intervertebral Discs ◽  
Herniated Disc ◽  
Intervertebral Disc Herniation ◽  
Postoperative Course ◽  
Outer Sheath

Study Design: A preliminary case series study.Purpose: For the safety of performing a posterior percutaneous full-endoscopic cervical discectomy.Overview of Literature: Because of the lack of space for inserting an outer sheath above the intervertebral disc in the spinal canal, grasping the herniated disc with forceps while retracting the nerves with the forceps itself was required. This procedure produces the risk of inadvertently injuring nerves because of inadequate visualization of the hernia and inadequate protection of the nerve.Methods: Our new internal retractor can be inserted into the working channel of a percutaneous full-endoscope, enabling the insertion of a second tool. After partial foraminotomy, the internal retractor and forceps were manipulated to reliably retract the nerve root. Finally, the herniated disc was resected under an endoscopic view.Results: All six cases had a good postoperative course, and postoperative neuropathy was not observed.Conclusions: This internal retractor allows for the secure resection herniated cervical intervertebral discs.

T9-T10 Intervertebral Disc Herniation in Three Dogs

1996 ◽  
Vol 09 (04) ◽  
pp. 177-178 ◽  
Author(s):  
R. Selcer ◽  
W. H. Adams ◽  
W. B. Thomas ◽  
B. E. Wilkens
Keyword(s):  
Spinal Cord ◽  
Intervertebral Disc ◽  
Disc Herniation ◽  
Intervertebral Discs ◽  
Postmortem Examination ◽  
Intervertebral Disc Herniation ◽  
Lumbar Region ◽  
Pain Sensation ◽  
Thoracolumbar Region ◽  
Disc Material

SummaryThree middle-aged (6-8 years), intact male Dachshunds were admitted to the University of Tennessee Veterinary Teaching Hospital (UTVTH) with acute onset of back pain and pelvic limb paralysis.Physical examination of dog #1 revealed hyperaesthesia of the thoracolumbar spine. Superficial pain sensation was absent in the pelvic limbs, while deep pain sensation was intact. The cutaneous trunci (panniculus) reflex was absent caudal to the thoraco-lumbar region. Reflexes to the pelvic limbs were exaggerated.A myelogram showed dorsal deviation of the ventral contrast column and attenuation of the ventral and dorsal contrast columns at the T9-T10 disc space. A hemilaminectomy was performed from T9 to T10, and mineralized disc material was retrieved from the vertebral canal at T9-T10. The T9- T10 to L3-L4 disc spaces were fenestrated. Two weeks after surgery, superficial and deep pain sensation of the rearlimbs were present, but paralysis persisted. The animal was euthanatised at the owners’ request. A postmortem examination was not performed.Dog #2 displayed absent superficial pain sensation, and intact deep pain sensation of the pelvic limbs. Hyperaesthesia of the thoracolumbar region and hyperreflexia of the rear limbs were noted. Examination of the cutaneous trunci reflex was not performed. A myelogram revealed ventral extradural compression of the spinal cord at T9- T10. A T9-T10 hemilaminectomy revealed a large amount of extruded disc material, which was removed. The Tll- T12 to L4-L5 intervertebral discs were fenestrated. Forty-eight hours postoperatively, the patient regained voluntary motor function, and recovery was uneventful.Neurologic examination of dog #3 revealed absence of deep pain sensation in the pelvic limbs; duration of which was not known. Spinal radiographs and myelography revealed ventral extradural spinal cord compression at T9-T10 (Fig.). A right-sided hemilaminectomy at T9-T10 revealed a large amount of calcified disc material, ventral to the spinal cord. The T11-T12 through Ll- L2 intervertebral discs were fenestrated. Sixty days postoperatively, paralysis persisted and the dog was euthanatised. No postmortem examination was performed.Herniation of the T9-T10 intervertebral disc was diagnosed in three Dachshunds with acute paraplegia. The clinical diagnosis and surgical management of T9-T10 disc herniation are similar to that in the more common sites of disc herniation.

scholarly journals Criteria for selection of patients with lumbar intervertebral disc herniation complicated by spinal canal stenosis

2021 ◽  
Vol 23 (6) ◽  
pp. 828-833
Author(s):  
T. А. Ksenzov ◽  
M. V. Khyzhniak ◽  
A. Ю. Ksenzov ◽  
V. О. Tyshchenko
Keyword(s):  
Intervertebral Disc ◽  
Disc Herniation ◽  
Spinal Canal ◽  
Disease Duration ◽  
Spinal Canal Stenosis ◽  
Intervertebral Disc Herniation ◽  
Mri Findings ◽  
Lumbar Intervertebral Disc ◽  
Canal Stenosis ◽  
Lumbar Intervertebral Disc Herniation

Aim – to evaluate clinical and instrumental correlation (MRI data) in patients with lumbar intervertebral disc herniation complicated by spinal canal stenosis for optimizing the indications for differentiated surgical treatment. Materials and methods. Clinical and neurological manifestations and MRI data in 80 patients (men – 36, women – 44), aged 27 to 72 years with a diagnosis of intervertebral disc herniation complicated by spinal canal stenosis were retrospectively analyzed. Depending on the size of the spinal canal, there were 2 groups: the first – with relative spinal canal stenosis (n = 20) – 75–100 mm2, and the second group – with absolute spinal canal stenosis (n = 60) – less than 75 mm2. We examined the correlation between the clinical and neurological presentations and MRI findings. Results. Our retrospective analysis has found that the first group consisted mainly of younger patients (46 years) and with a mean intervertebral disc herniation of 8.35 mm, while the second group included older patients (51.7 years) and the mean size of intervertebral disc herniation was 7.3 mm. The group of relative spinal canal stenosis was dominated by patients with radiculopathy syndrome (70 %) and pain in one lower limb (85 %). Radiculoischemia syndrome (50 %), pain in both lower extremities (33 %), neurogenic intermittent claudication syndrome (46.6 %), knee reflex disorders (58.3 %), pelvic organ dysfunction (11.6 %) were more common in the second group of patients. In addition, the longest disease duration (more than 24 months) was observed among patients of this group. We have found a relationship between pain syndrome (according to VAS), muscle strength, the disease duration and the spinal canal area. Conclusions. The correlation of clinical and instrumental methods of examination in patients with intervertebral disc herniation complicated by spinal canal stenosis allows the indications for differentiated surgery to be optimized.

scholarly journals Spontaneous regression of lumbar herniated disc Case presentation

2015 ◽  
Vol 29 (4) ◽  
pp. 381-384 ◽  
Author(s):  
A. Chiriac ◽  
Giorgiana Ion ◽  
Z. Faiyad ◽  
I. Poeata
Keyword(s):  
Conservative Treatment ◽  
Intervertebral Disc ◽  
Clinical Improvement ◽  
Spontaneous Regression ◽  
Surgical Intervention ◽  
Herniated Disc ◽  
Common Disease ◽  
Intervertebral Disc Herniation ◽  
Case Presentation

Abstract Intervertebral disc herniation is a common disease that usually requires surgical intervention. However, in some cases, neurological symptoms may improve with conservative treatment. In this article, we present a case with spontaneous regression of extruded lumbar herniated disc correlated with clinical improvement and documented with follow up MRI studies.

Computed tomographic and histological findings of Hansen type I intervertebral disc herniation in dogs

2013 ◽  
Vol 26 (05) ◽  
pp. 379-384 ◽  
Author(s):  
C. L. Vitale ◽  
S. C. Essman ◽  
P. Pithua ◽  
J. R. Coates ◽  
K. Kuroki
Keyword(s):  
Intervertebral Disc ◽  
Disc Herniation ◽  
Imaging Modality ◽  
Thoracolumbar Spine ◽  
Herniated Disc ◽  
Intervertebral Disc Herniation ◽  
Type I ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Enhanced Ct

SummaryObjective: To evaluate whether noncontrast-enhanced computed tomography (CT) as a stand-alone imaging modality can be used to define the Hansen type I intervertebral disc herniation (IVDH) lesion and also whether the Hounsfield unit (HU) value of herniated disc is relevant to clinical duration and to histopathological chronicity of extruded disc material.Methods: Information from a series of CT studies performed on 45 dogs with a presumptive diagnosis of Hansen type I IVDH was used. Clinical duration of IVDH was estimated based on time from onset of signs per owner communication to time of surgical intervention. Hansen type I IVDH was confirmed at surgery. Retrieved herniated disc was histologically examined. The HU values were analyzed to correlate the clinical duration and histopathological chronicity of the disc lesion.Results: Non-contrast-enhanced CT provided sufficient diagnostic information to plan surgery in 42 of 45 dogs (93%). The value of the HU was significantly higher in clinically chronic cases (n = 12) compared to peracute cases (n = 11) (p <0.05). The HU values were significantly correlated with clinical duration (r = 0.482, p = 0.0008) and histopathological chronicity of the herniated disc (r = 0.408, p = 0.0056).Conclusion: Consistent with the previous reports, the use of non-contrast-enhanced CT alone was sufficient for the diagnosis and surgical planning in most patients with Hansen type I IVDH in the thoracolumbar spine. In addition, the present study suggested that HU values on CT images may be useful in the evaluation of disease chronicity of IVDH.

scholarly journals Ventral Slot Surgery to Manage Cervical Intervertebral Disc Disease in Three Cats

2018 ◽  
Vol 31 (01) ◽  
pp. 071-076
Author(s):  
Rodolfo Cappello ◽  
Akash Alexander ◽  
Steven De Decker ◽  
Abbe Crawford
Keyword(s):  
Intervertebral Disc ◽  
Cervical Spinal Cord ◽  
Case Series ◽  
Intervertebral Disc Herniation ◽  
Intervertebral Disc Disease ◽  
Retrospective Case ◽  
Disc Disease ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Neurological Improvement

Objective This case series describes the clinical presentation, management and outcome of three cats diagnosed with cervical intervertebral disc disease that underwent decompressive ventral slot surgery. Methods This is a retrospective case series evaluating client-owned cats undergoing a ventral slot surgical procedure to manage cervical intervertebral disc disease (n = 3). Results A routine ventral slot surgery was performed in each case without complication, resulting in postoperative neurological improvement in all three cases. Clinical Significance Ventral slot surgery can be used to achieve effective cervical spinal cord decompression with a good long-term outcome in the management of feline cervical intervertebral disc herniation. To avoid creating an excessively wide slot with the potential for postoperative complications including vertebral sinus haemorrhage, vertebral instability or ventral slot collapse, careful surgical planning was performed with preoperative measurement of the desired maximum slot dimensions.

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.

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