Cystometry as an adjunct in the evaluation of lumbar disc syndromes

1970 ◽  
Vol 33 (1) ◽  
pp. 67-74 ◽  
Author(s):  
Hubert L. Rosomoff ◽  
John D. H. Johnston ◽  
Anthony E. Gallo ◽  
Mario Ludmer ◽  
Frederick T. Givens ◽  
...  
Keyword(s):  
Nerve Root ◽  
Lumbar Disc ◽  
Nerve Root Compression ◽  
Content Type ◽  
Sensory Deficits ◽  
Lumbar Nerve Root ◽  
Neurophysiological Mechanisms ◽  
Somatic Nervous System ◽  
Almost All ◽  
Bladder Evaluation

✓ One hundred patients with the provisional diagnosis of nerve root compression in the lumbar spine were subjected to routine bladder evaluation by cystometry in addition to the standard somatic neurological examination. Eighty-three were found to have cystometrograms characteristic of bladder hypofunction. Residual urine was found in 20% of the 100 patients. By contrast, the examination of the somatic nervous system disclosed sensory deficits in 36%, weakness in 59%, reflex alterations in 66%, and positive sciatic-stretch tests in 69%. Almost all cystometric studies (96%) became normal after successful surgical or conservative therapy. It is concluded that occult bladder dysfunction is a major manifestation of lumbar nerve root compression. The neurophysiological mechanisms involved are discussed in detail.

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.

Lumbar nerve root compression at the intervertebral foramina caused by arthritis of the posterior facets

1973 ◽  
Vol 39 (3) ◽  
pp. 362-369 ◽  
Author(s):  
Joseph A. Epstein ◽  
Bernard S. Epstein ◽  
Leroy S. Lavine ◽  
Robert Carras ◽  
Alan D. Rosenthal ◽  
...  
Keyword(s):  
Nerve Root ◽  
Herniated Disc ◽  
Nerve Root Compression ◽  
Degenerative Arthritis ◽  
Content Type ◽  
Lumbar Nerve Root ◽  
Intervertebral Foramina ◽  
Pain Patients ◽  
Unusual Stress ◽  
Fine Print

✓ The authors report their experience with 12 cases in which the roots of the sciatic nerve were compressed at the intervertebral foramina by degenerative arthritis (arthrosis) of the posterior facets, and in which foraminotomy and facetectomy brought relief of pain. Patients with disc narrowing, spondylolisthesis, and transitional vertebrae place unusual stress on the posterior facets. This may lead to hypertrophy and the development of marginal osteophytes that project downward with eventual constriction of the intervertebral foramen and entrapment of the nerve root. Such alterations are common in patients over 40, and when found in the presence of unremitting sciatic pain without evidence of a herniated disc or other etiology, a causal relationship must be considered.

Lumbar nerve root compression by synovial cysts of the ligamentum flavum

1984 ◽  
Vol 60 (3) ◽  
pp. 617-620 ◽  
Author(s):  
Adel F. Abdullah ◽  
Robert W. Chambers ◽  
Dennis P. Daut
Keyword(s):  
Nerve Root ◽  
Ligamentum Flavum ◽  
Nerve Root Compression ◽  
Nerve Roots ◽  
Content Type ◽  
Lumbar Nerve Root ◽  
Synovial Cysts ◽  
Fine Print

✓ Synovial cysts of the ligamentum flavum, measuring 1 cm in diameter, caused compression of the lumbar nerve roots in four patients. The authors discuss the association of these cysts with advanced focal spondylosis, and speculate on their etiology.

Pneumatic nerve root compression: epidural gas in association with lateral disc herniation

1994 ◽  
Vol 81 (3) ◽  
pp. 453-458 ◽  
Author(s):  
Theresa M. Cheng ◽  
Michael J. Link ◽  
Burton M. Onofrio
Keyword(s):  
Disc Herniation ◽  
Nerve Root ◽  
Chronic Back Pain ◽  
Intervertebral Discs ◽  
Leg Pain ◽  
Nerve Root Compression ◽  
Disc Space ◽  
Content Type ◽  
Lumbar Nerve Root ◽  
Epidural Gas

✓ Extreme lateral disc herniations are increasingly recognized as a cause of lumbar nerve root compression syndromes. This disorder often presents major diagnostic and therapeutic challenges, especially in the presence of multiple degenerative changes and chronic back pain in elderly patients. The authors describe two patients with presentations and findings that have not been previously described in the literature. Both patients had histories of upper lumbar back and leg pain. Degenerative spine disease, gaseous degeneration of the intervertebral discs, and epidural gas in the lateral recesses were noted on imaging studies. However, because both patients had undergone prior epidural diagnostic and therapeutic procedures, the epidural gas in the lateral recesses could be attributed either to gaseous disc degeneration or to the previous intraspinal procedures. One patient was found to have a large, far lateral extruded disc fragment that contained air. The nerve root in the second patient was impaled by an unusual combination of a small extruded disc fragment as well as an air-filled sac that was surrounded by the walled-off fragment's capsule and which freely communicated with the gaseous degenerated disc space. The suspected mechanism of root compression is illustrated and discussed. The possibility of disc herniation should be seriously considered in cases of nerve root compression in which epidural gas is present, especially those associated with gaseous degenerated discs.

Lumbosacral intersegmental epispinal axons and ectopic ventral nerve rootlets

1987 ◽  
Vol 67 (2) ◽  
pp. 269-277 ◽  
Author(s):  
Wesley W. Parke ◽  
Ryo Watanabe
Keyword(s):  
Nerve Root ◽  
Sensory Nerve ◽  
Conus Medullaris ◽  
Spinal Nerve ◽  
Nerve Fibers ◽  
Ventral Horn ◽  
Spinal Nerve Roots ◽  
Nerve Roots ◽  
Content Type ◽  
Almost All

✓ An epispinal system of motor axons virtually covers the ventral and lateral funiculi of the human conus medullaris between the L-2 and S-2 levels. These nerve fibers apparently arise from motor cells of the ventral horn nuclei and join spinal nerve roots caudal to their level of origin. In all observed spinal cords, many of these axons converged at the cord surface and formed an irregular group of ectopic rootlets that could be visually traced to join conventional spinal nerve roots at one to several segments inferior to their original segmental level; occasional rootlets joined a dorsal nerve root. As almost all previous reports of nerve root interconnections involved only the dorsal roots and have been cited to explain a lack of an absolute segmental sensory nerve distribution, it is believed that these intersegmental motor fibers may similarly explain a more diffuse efferent distribution than has previously been suspected.

Traumatic lumbar nerve root meningocele

1973 ◽  
Vol 39 (4) ◽  
pp. 528-532 ◽  
Author(s):  
James E. McLennan ◽  
William T. McLaughlin ◽  
Stanley A. Skillicorn
Keyword(s):  
Functional Recovery ◽  
Nerve Root ◽  
Surgical Intervention ◽  
Nerve Roots ◽  
Content Type ◽  
Lumbar Nerve Root ◽  
Fine Print

✓ A patient is described who developed an acute, occult, lumbosacral nerve root meningocele following a partial traumatic avulsion of the L-4 and L-5 nerve roots accompanied by fracture of the pelvis and fibula. Almost total functional recovery ensued. The differences between acute and chronic nerve root meningoceles are discussed, as well as the possibility of surgical intervention.

scholarly journals Is NICE guidance for identifying lumbar nerve root compression misguided?

2014 ◽  
Vol 23 (S1) ◽  
pp. 20-24 ◽  
Author(s):  
Tim Germon ◽  
William Singleton ◽  
Jeremy Hobart
Keyword(s):  
Nerve Root ◽  
Nerve Root Compression ◽  
Lumbar Nerve Root ◽  
Nice Guidance

Intraradicular herniated lumbar disc

1984 ◽  
Vol 60 (4) ◽  
pp. 858-860 ◽  
Author(s):  
José Barberá ◽  
José Gonzalez-Darder ◽  
Fernando García-Vazquez
Keyword(s):  
Nerve Root ◽  
Unusual Case ◽  
Lumbar Disc ◽  
Content Type ◽  
Pathogenic Factors ◽  
Herniated Lumbar Disc ◽  
Fine Print

✓ An unusual case is presented in which a fragment of herniated lumbar disc was found within the sheath of the S-1 nerve root. The possible pathogenic factors are discussed.

Spinal meningioma arising from a lumbar nerve root

1989 ◽  
Vol 70 (4) ◽  
pp. 646-648 ◽  
Author(s):  
Thomas H. K. Ng ◽  
Kwan Hon Chan ◽  
Kirpal S. Mann ◽  
Ching F. Fung
Keyword(s):  
Nerve Root ◽  
Cauda Equina ◽  
Spinal Meningioma ◽  
Content Type ◽  
Cauda Equina Compression ◽  
Lumbar Nerve Root ◽  
Fine Print

✓ A case is reported of cauda equina compression from an intradural meningioma arising from the L-5 nerve root in a young man.

Changes in nerve root motion and intraradicular blood flow during intraoperative femoral nerve stretch test

2003 ◽  
Vol 99 (3) ◽  
pp. 298-305 ◽  
Author(s):  
Shigeru Kobayashi ◽  
Yoshihiko Suzuki ◽  
Takahiro Asai ◽  
Hidezo Yoshizawa
Keyword(s):  
Blood Flow ◽  
Disc Herniation ◽  
Standard Error ◽  
Nerve Root ◽  
Lumbar Disc ◽  
Femoral Nerve ◽  
Nerve Roots ◽  
Content Type ◽  
The Mean ◽  
Fine Print

Object. It is not known whether changes in intraradicular blood flow (IRBF) occur during the femoral nerve stretch test (FNST) in patients with lumbar disc herniation. An FNST was conducted in patients with lumbar disc herniation to observe the changes in IRBF, and results were then compared with clinical features. Methods. The study was composed of four patients with L3–4 disc herniation who underwent microdiscectomy. Patients were placed prone immediately before surgery, so that their knee flexed on the operating table with the hip joint kept in hyperextension, and the FNST was performed to confirm at which region pain developed in the anterolateral thigh. During the operation, the hernia-affected nerve roots were visualized under a microscope. The needle sensor of a laser Doppler flowmeter was then inserted into each nerve root immediately above the hernia, and the change in IRBF was measured during the intraoperative FNST. After removal of the herniated disc, a similar procedure was repeated and IRBF was measured again. The intraoperative FNST showed that the hernia compressed the nerve roots and there was marked disturbance of gliding, which was reduced to only a few millimeters. During the test, IRBF decreased by 92.8 to 100% (mean 96.9 ± 3.7% [± standard error of the mean]) relative to the blood flow before the test. This study demonstrated that the blood flow in the nerve root is reduced when the nerve root is compressed in vivo. Conclusions. The intraoperative FNST showed that the hernia compressd the nerve roots and there was marked disturbance of gliding, which was reduced to only a few millimeters. During the test, IRBF decreased by 92.8 to 100% (96.9 ± 3.7% [mean ± standard error of the mean]).

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