Surgical treatment of 63 cases of conjoined nerve roots

1982 ◽  
Vol 56 (1) ◽  
pp. 114-117 ◽  
Author(s):  
James G. White ◽  
Timothy A. Strait ◽  
Joseph R. Binkley ◽  
Samuel E. Hunter
Keyword(s):  
Surgical Treatment ◽  
Lumbar Disc ◽  
Disc Disease ◽  
Nerve Roots ◽  
Lumbar Disc Disease ◽  
Content Type ◽  
Operative Results ◽  
Conjoined Nerve Roots ◽  
Conjoined Nerve Root ◽  
Fine Print

✓ The operative results of 63 cases of lumbar disc disease with surgically confirmed conjoined nerve roots are reviewed. The first 55 patients were treated by standard hemilaminectomy and discectomy, with only 30% reporting a good result. Of the last eight patients treated by hemilaminectomy, pediculectomy, and discectomy, seven patients returned to work. The rationale for and the technique of pediculectomy are discussed in detail. Clinical, radiological, and surgical clues indicating the presence of the conjoined nerve root anomaly are reviewed.

Diabetic polyradiculopathy simulating lumbar disc disease

1984 ◽  
Vol 60 (1) ◽  
pp. 183-186 ◽  
Author(s):  
Leonard F. Hirsh
Keyword(s):  
Lumbar Disc ◽  
Spinal Nerve ◽  
Spinal Diseases ◽  
Endocrine Disorders ◽  
Disc Disease ◽  
Nerve Roots ◽  
Lumbar Disc Disease ◽  
Content Type ◽  
The Common ◽  
Neurological Effects

✓ Most clinicians are aware of the common neurological effects of endocrine disorders. However, involvement of the spinal nerve roots is a poorly recognized complication of diabetes mellitus. Such involvement can closely simulate more common spinal diseases and thus lead to inappropriate therapy. Four cases of diabetic polyradiculopathy simulating lumbar disc disease are reported, and this distinctive entity is reviewed.

A novel surgical treatment of lumbar disc herniation in patients with long-standing degenerative disc disease

2005 ◽  
Vol 2 (5) ◽  
pp. 515-520 ◽  
Author(s):  
Markus Wenger ◽  
Thomas-Marc Markwalder
Keyword(s):  
Surgical Treatment ◽  
Lumbar Disc Herniation ◽  
Degenerative Disc Disease ◽  
Lumbar Disc ◽  
Herniated Disc ◽  
Total Disc Arthroplasty ◽  
Disc Disease ◽  
Disc Arthroplasty ◽  
Content Type ◽  
Fine Print

Object. In patients with long-standing lumbar degenerative disc disease (DDD) conventional surgical therapy of a herniated disc may worsen back pain due to further destabilization of the affected motion segment. In recent years, total-disc arthroplasty has been introduced to treat DDD while maintaining segmental mobility. To the best of the authors' knowledge, this is the first report involving lumbar disc herniation and long-standing DDD submitted to combined anterior microdiscectomy with sequestrectomy and total-disc arthroplasty. Methods. Fourteen patients with long-standing DDD and a recently herniated disc underwent total anterior lumbar microdiscectomy, with removal of the herniated disc, and total-disc arthroplasty. There were nine women and five men whose mean age was 39.6 years (range 22–56 years) in whom back and leg pain had been present for a mean of 75.4 (range 9–360) and 9.4 (range 0.33–36) months, respectively. Thirteen patients underwent L5—S1 and one underwent L4–5 surgery. In all cases the procedure and the postoperative courses were uneventful. After a mean follow-up period of 12.5 months (range 3.9–21.1 months), outcome was excellent in 11 and good in three patients. Conclusions. The aforementioned surgical treatment of a recently herniated lumbar disc in patients with long-standing DDD yielded very favorable early results.

Surgically treated lumbar disc disease in the pediatric population: an outcome study

2000 ◽  
Vol 92 (1) ◽  
pp. 1-6 ◽  
Author(s):  
Susan R. Durham ◽  
Peter P. Sun ◽  
Leslie N. Sutton
Keyword(s):  
Back Pain ◽  
Pediatric Population ◽  
Lumbar Disc ◽  
Disc Disease ◽  
Lumbar Disc Disease ◽  
Content Type ◽  
Sf 36 ◽  
Study Population ◽  
Fine Print

Object. This outcome study was undertaken to investigate the long-term results obtained in surgically treated pediatric patients with lumbar disc disease by using standardized medical outcome scales and clinical follow-up examination. Methods. Twenty nine patients 17 years of age or younger underwent surgery between 1968 and 1998 for lumbar disc disease. The follow-up period ranged from 4 months to 30.5 years (mean 8.5 years). Outcome scores (health profiles) were generated using a standardized medical outcome scale, the Short Form health survey questionnaire (SF-36), and a condition-specific back pain outcome scale. Clinical follow-up data were obtained by telephone interview. The health profile of the study population closely paralleled that of the normal population and was distinctly different from the health profile of adults with low-back pain. Only physical functioning, as measured by a scale of the SF-36, was found to be impaired in a subset of the study population. The rate of reoperation was 24% over the course of the follow-up period. In contrast to similar studies in adults, there were no identifiable predictive factors for either reoperation or poor outcome. Conclusions. Lumbar disc disease in the pediatric population does not appear to lead to chronic complaints of back pain, and it does not appear to have a negative impact on overall health. This finding suggests that pediatric lumbar disc disease may be a separate entity distinct from adult lumbar disc disease, and therefore, the same conclusions regarding long-term outcome cannot be applied to the pediatric population.

Lumbosacral myelography with Dimer-X

1973 ◽  
Vol 39 (3) ◽  
pp. 359-361 ◽  
Author(s):  
Isaac Z. Kosary ◽  
Rina Tadmor ◽  
George Ouaknine ◽  
Jackson Braham
Keyword(s):  
Side Effects ◽  
Contrast Media ◽  
Contrast Medium ◽  
Lumbar Disc ◽  
Water Soluble ◽  
Disc Disease ◽  
Lumbar Disc Disease ◽  
Content Type ◽  
Fine Print

✓ The authors report the use of the water-soluble spinal contrast medium Dimer-X in 100 cases of suspected lumbar disc disease. It was particularly valuable in delineating small laterally-placed protrusions causing root compression, which are often difficult to demonstrate with oily contrast media. Side effects were mild and transient, and no serious complications were encountered.

Spinal subarachnoid hemorrhage during myelography

1978 ◽  
Vol 48 (4) ◽  
pp. 645-648 ◽  
Author(s):  
John F. Rice ◽  
Christopher B. Shields ◽  
Charles F. Morris ◽  
Byron D. Neely
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Lumbar Disc ◽  
Fluid Pressure ◽  
Cauda Equina ◽  
Conus Medullaris ◽  
Disc Disease ◽  
Lumbar Disc Disease ◽  
Content Type ◽  
Spinal Subarachnoid Hemorrhage ◽  
Fine Print

✓ Neoplasms of the conus medullaris and cauda equina have been shown to cause subarachnoid hemorrhage (SAH). In such instances, the hemorrhage has been the presenting symptom. A patient with a neurofibroma at T12—L1 experienced spinal SAH during myelography for suspected lumbar disc disease. The roentgenograms showing the lesion itself first and the subarachnoid clot subsequently may be unique. The cause of hemorrhage in this patient may have been the shearing of bridging capsular veins because of diminished cerebrospinal fluid pressure below the almost obstructing lesion.

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]).

scholarly journals Outcome of Surgical Treatment for Lumber Disc Herniation Causing Painful Incomplete Foot-Drop

2020 ◽  
Vol 24 (3) ◽  
Author(s):  
MUSAWER KHAN ◽  
AKRAM ULLAH ◽  
ADNAN AHMED ◽  
MUMTAZ ALI ◽  
MANSOOR AHMAD
Keyword(s):  
Surgical Treatment ◽  
Pain Relief ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Cauda Equina ◽  
Foot Drop ◽  
Disc Disease ◽  
Lumbar Disc Disease ◽  
Number Of Patients

Objective:  To determine the outcome of surgical treatment for lumder disc herniation causing the painful incomplete foot drop. Material and Methods:  This retrospective observational study was conducted at the Department of Neurosurgery Lady Reading Hospital, Peshawar. Both Male and female patients with lumbar disc disease causing unilateral incomplete painful foot drop were included in our study. Patients with complete or painless foot drop, bilateral foot-drop, Multiple level disc prolapse, cauda equina syndrome or sciatic neuropathy due to injection injury were excluded. Patients were followed was post-operatively in terms of power in foot dorsiflexion, medical research council (MRC) grade and pain relief  on a Visual Analogue Scale (VAS) after 1 month and then after 6 months. Results: Total number of patients included were 43. Age was ranging from 18 years to 54 years and mean age was 33 years. Before surgery,  power of MRC grade 3 or less, but greater than 1 in dorsiflexion was noted in all patients. The pain was scaled using VAS. Post peratively, at 1 month follow up, the foot-drop improved to MRC grade 4 or 5 along with pain relief of ≥ 2 points on VAS in 81. 4% (n = 35) patients and at 6 month follow-up, the figure rose to 93% (n = 40). Conclusion:  Lumbar disc disease can cause a debilitating foot-drop and pain. Improving or restoring a neurology early surgical intervention has proven benefits.

Cerebral angiomas: the sequelae of surgical treatment

1972 ◽  
Vol 37 (5) ◽  
pp. 571-575 ◽  
Author(s):  
A. Loren Amacher ◽  
John M. Allcock ◽  
Charles G. Drake
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Surgical Treatment ◽  
Mortality Rate ◽  
Content Type ◽  
Postoperative Death ◽  
Operative Results ◽  
Intractable Seizures ◽  
Indications For Operation ◽  
Fine Print

✓ Fifty patients underwent 55 operations upon intracerebral angiomas; 86% had suffered intracerebral or subarachnoid hemorrhage, 8% intractable seizures, and 6% intractable headache and progressive ischemic symptoms. There was one postoperative death, a mortality rate of 2%. The operative results are considered in relation to the indications for operation and the degree of removal. The importance of postoperative angiography is stressed.

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