Extraosseous extradural tuberculous granuloma simulating a herniated lumbar disc

1971 ◽  
Vol 35 (4) ◽  
pp. 488-490 ◽  
Author(s):  
S. Balaparameswara Rao ◽  
I. Dinakar ◽  
K. Sreenivasa Rao
Keyword(s):  
Cerebrospinal Fluid ◽  
Granulation Tissue ◽  
Lumbar Disc ◽  
Disc Prolapse ◽  
Content Type ◽  
X Ray ◽  
Herniated Lumbar Disc ◽  
Tuberculous Granuloma ◽  
Fine Print

✓ A 25-year-old man with left-sided sciatica, in whom the cerebrospinal fluid and x-ray films of the spine were normal, was diagnosed as having a L5-S1 disc prolapse. At surgery extradural, extraosseous granulation tissue was removed, which histologically proved to be a tuberculous granuloma.

Efficacy of chymopapain chemonucleolysis

1985 ◽  
Vol 62 (5) ◽  
pp. 662-666 ◽  
Author(s):  
Manucher J. Javid
Keyword(s):  
Marked Improvement ◽  
Lumbar Disc ◽  
Slight Improvement ◽  
Content Type ◽  
Herniated Lumbar Disc ◽  
Fine Print

✓ A 9- to 12-year follow-up review was conducted in 105 of 124 patients who were treated with chymopapain chemonucleolysis for herniated lumbar disc. The data were obtained from responses to a questionnaire. Seventy-nine patients (75.2%) reported marked improvement, six (5.7%) had slight improvement, and 20 (19.0%) had no improvement. Of the 87 patients not receiving workman's compensation, 70 patients (80.5%) had marked improvement; four (4.6%) had slight improvement; and 13 (14.9%) had no improvement. Of the 18 compensation cases, nine patients (50.0%) had marked improvement; two patients (11.1%) had slight improvement; and seven patients (38.9%) had no improvement. These results are comparable to those reported for surgical discectomy, and confirm that chymopapain chemonucleolysis is an alternative to surgery.

Unilateral facetectomy approach for lateral lumbar disc herniation

1991 ◽  
Vol 74 (5) ◽  
pp. 754-756 ◽  
Author(s):  
Eddy Garrido ◽  
P. Noel Connaughton
Keyword(s):  
Disc Herniation ◽  
Lumbar Fusion ◽  
Lumbar Disc ◽  
Herniated Disc ◽  
Spinal Instability ◽  
Content Type ◽  
X Ray ◽  
Flexion And Extension ◽  
Fine Print

✓ Forty-one patients with herniated lumbar discs in a lateral location underwent unilateral complete facetectomy for removal of their disc herniation. The diagnosis was made by computerized tomography in all patients. The follow-up period varied between 4 and 60 months, with an average of 22.4 months. All patients underwent dynamic lumbar spine x-ray films with flexion and extension exposures at various times during their follow-up period. The results were excellent in 35 patients, good in three, and poor in three. One patient suffered spinal instability postoperatively and required lumbar fusion because of back pain. Unilateral facetectomy gives an excellent view of the affected nerve root and the herniated disc, and the risk of spinal instability is very low.

Syndrome of the incidental herniated lumbar disc

1983 ◽  
Vol 59 (1) ◽  
pp. 137-141 ◽  
Author(s):  
James E. Wilberger ◽  
Dachling Pang
Keyword(s):  
Clinical Features ◽  
Lumbar Disc Herniation ◽  
Lumbar Disc ◽  
Herniated Disc ◽  
Content Type ◽  
Asymptomatic Patients ◽  
Appropriate Treatment ◽  
Herniated Lumbar Disc ◽  
Fine Print

✓ Lumbar myelographic defects consistent with herniated disc were found in 108 asymptomatic patients undergoing myelography for other reasons. Within 3 years, 64% of these patients developed symptoms of lumbosacral radiculopathy. The clinical features of these patients comprise a syndrome significantly different from that typically associated with classical lumbar disc herniation: the syndrome described here carries a much higher incidence of silent root compression with minimal pain. Incidental lumbar myelographic defects are not necessarily benign findings, and patients in whom they are encountered deserve close clinical follow-up review and appropriate treatment if the defects become symptomatic.

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.

Delineation of the obex by contrast radiography during percutaneous trigeminal tractotomy

1972 ◽  
Vol 36 (1) ◽  
pp. 107-112 ◽  
Author(s):  
John L. Fox
Keyword(s):  
Cerebrospinal Fluid ◽  
Medulla Oblongata ◽  
Fourth Ventricle ◽  
Content Type ◽  
X Ray ◽  
Cisterna Magna ◽  
Contrast Radiography ◽  
Fine Print

✓ Accuracy of percutaneous implantation of an electrode into the descending trigeminal tract can be improved substantially by contrast radiography. A translateral x-ray film taken after 1 cc of Pantopaque emulsified with 1 cc of cerebrospinal fluid has been injected by midline puncture of the cisterna magna will outline the floor of the fourth ventricle, the obex, and the dorsum of the medulla oblongata. Injection is made under mild pressure and with the patient prone. This technique has been used successfully on 12 patients.

Disappearing cervical disc

1997 ◽  
Vol 86 (2) ◽  
pp. 289-290 ◽  
Author(s):  
Richard M. Westmark ◽  
Kaye D. Westmark ◽  
Volker K. H. Sonntag
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Lumbar Disc ◽  
Spontaneous Resolution ◽  
Herniated Disc ◽  
Cervical Disc ◽  
Resonance Imaging ◽  
Content Type ◽  
Herniated Lumbar Disc ◽  
Fine Print

✓ The authors report the case of a 48-year-old woman who experienced spontaneous resolution of a large herniated disc at C6–7. Spontaneous resolution of a herniated lumbar disc was first documented by computerized tomography. This case is another example of a rare spontaneous resolution of a cervical disc herniation documented by magnetic resonance imaging.

An investigation of structural degradation of cerebrospinal fluid shunt valves performed using scanning electron microscopy and energy-dispersive x-ray microanalysis

2004 ◽  
Vol 100 (3) ◽  
pp. 534-540 ◽  
Author(s):  
Spyros Sgouros ◽  
Susan J. Dipple
Keyword(s):  
Electron Microscopy ◽  
Scanning Electron Microscopy ◽  
Cerebrospinal Fluid ◽  
Energy Dispersive ◽  
Ventricular Catheter ◽  
Content Type ◽  
X Ray ◽  
Programmable Valve ◽  
Fine Print ◽  
Scanning Electron

Object. Surveys of cerebrospinal fluid (CSF) shunts that have been removed from patients have shown that even when the ventricular catheter is the cause of the obstruction, the valve may be obstructed or underperforming. The aim of this pilot study was to investigate the degradation of shunt valve structure over time due to the deposition of debris. The findings were compared with findings in unused valves. Methods. Scanning electron microscopy was used to visualize the structures of the valves. The items that were examined included two unused and nine explanted cylindrical medium pressure valves, one unused and six explanted Delta 1.5 valves (PS Medical, Goleta, CA), and one explanted Medos Programmable valve (Codman Johnson & Johnson, LeLocle, Switzerland). The valves were cut open, disassembled, and coated in gold. The areas that were analyzed included the main valve chamber, the diaphragm unit, and the antisiphon device. For areas with abnormal deposits, energy-dispersive x-ray microanalysis was performed to establish the chemical composition of the deposits. The reference unused valves had smooth surfaces with no deposits in any areas. All explanted valves had extensive deposits in all surveyed areas. The deposits varied from small clusters of crystals to large areas that displayed a cobblestone appearance. In diaphragm valves the deposits extensively affected the surface of the diaphragm and the gap between the diaphragm and the surrounding case, where normally CSF flows; in the Medos valve the deposits affected in the spring and “staircase” unit. Deposits were present as early as 2 weeks after implantation. On some valves there was a complete film covering the entire outlet of the valve, which formed a cast inside the valve stretching from wall to wall. The deposits consisted mostly of sodium and chloride, but occasionally contained calcium. In all infected and some noninfected valves there was a significant peak of carbon, indicating the presence of protein deposits. Conclusions. It appears that the continuous flow of CSF through shunt valves causes surface deposits of sodium chloride and other crystals on all aspects of the valve, including the outlet pathways. The formation of deposits may be encouraged by the adhesive properties of the materials that constitute the valve parts.

Double-blind evaluation of intradiscal chymopapain for herniated lumbar discs

1976 ◽  
Vol 45 (6) ◽  
pp. 622-627 ◽  
Author(s):  
P. Robert Schwetschenau ◽  
Archimedes Ramirez ◽  
James Johnston ◽  
Elnora Barnes ◽  
Albert N. Martins
Keyword(s):  
Conservative Treatment ◽  
Lumbar Disc ◽  
Intractable Pain ◽  
Double Blind ◽  
Content Type ◽  
Early Results ◽  
Significant Difference ◽  
Herniated Lumbar Disc ◽  
Fine Print

✓ The authors report 66 patients with signs, symptoms, and a myelographic abnormality of herniated lumbar disc, who were not responsive to conservative treatment. The discs were injected at random with either chymopapain or a placebo. Neither patient nor surgeon knew which agent was used until after the results had been tabulated. Unless early laminectomy was necessary for intractable pain, all patients were followed for 2 months or more. There was no statistically significant difference in incidence or quality of improvement between the two groups: chymopapain was successful in 58% while placebo was successful in 49% (p = 0.15). Early results from this study indicate that most, if not all, of the putative effectiveness of chemonucleolysis probably derives from a placebo effect.

Intracranial lipoma

1980 ◽  
Vol 52 (2) ◽  
pp. 234-245 ◽  
Author(s):  
Ekkehard Kazner ◽  
Otto Stochdorph ◽  
Sigurd Wende ◽  
Thomas Grumme
Keyword(s):  
Cerebrospinal Fluid ◽  
Surgical Approach ◽  
Clinical Symptoms ◽  
Ct Scanning ◽  
Shunt Operation ◽  
Content Type ◽  
X Ray ◽  
Intracranial Lipoma ◽  
X Ray Absorption ◽  
Fine Print

✓ Eleven cases of intracranial lipoma, diagnosed during life by computerized tomography (CT) scanning, are presented. Clinical symptoms related to the lesions were present in eight. The CT scan establishes the diagnosis of intracranial lipoma on the basis of typical x-ray absorption and location. Only dermoid cysts and teratomas may produce a similar CT appearance. In cases of intracranial lipoma, a direct surgical approach is seldom necessary, although in certain locations, lipomas may cause blockage of cerebrospinal fluid pathways and require a shunt operation.

Cerebrospinal fluid fistula from fractured acrylic cranioplasty plate

1976 ◽  
Vol 45 (2) ◽  
pp. 227-228 ◽  
Author(s):  
Harvey M. Henry ◽  
Caesar Guerrero ◽  
Robert A. Moody
Keyword(s):  
Cerebrospinal Fluid ◽  
Methyl Methacrylate ◽  
Cerebrospinal Fluid Fistula ◽  
Content Type ◽  
X Ray ◽  
External Evidence ◽  
Fluid Fistula ◽  
Fine Print

✓ The authors report a patient who developed a cerebrospinal fluid fistula secondary to a fractured methyl methacrylate cranioplasty plate. There was no external evidence of trauma. X-ray films showed no evidence of the fracture. It is suggested that the impregnation of methyl methacrylate with a radiopaque material would result in visualization of such fractures.

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