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.

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.

The long-term results of chymopapain chemonucleolysis for lumbar disc disease

1986 ◽  
Vol 65 (1) ◽  
pp. 1-8 ◽  
Author(s):  
Robert J. Maciunas ◽  
Burton M. Onofrio
Keyword(s):  
Surgical Procedures ◽  
Lumbar Disc ◽  
Leg Pain ◽  
Long Term Results ◽  
Disc Disease ◽  
Lumbar Disc Disease ◽  
Content Type ◽  
Work Related ◽  
Effective Treatment Modality

✓ The long-term clinical outcome is evaluated for 268 patients after chymopapain chemonucleolysis for radicular complaints referrable to documented intervertebral disc disease. The follow-up period for 92% of these patients was 10 years. No complications due to chymopapain toxicity were observed; 80.1% of patients were relieved of their presenting radicular leg pain and 75.1% were employed at a capacity equal to or more strenuous than before injection. Chemonucleolysis was demonstrated to be a safe and effective treatment modality, with long-term results that compare favorably with those of similarly selected patients undergoing open surgical procedures. In the patients whose chymopapain therapy failed, the outcome of subsequent open surgical procedures was not necessarily compromised by prior chemonucleolysis. A higher rate of failure and subsequent surgical intervention was seen in those patients with injections performed soon after an unsuccessful open procedure on the same side and at the same interspace, those with workmen's compensation or litigation pending, those with a history of work-related injury, those whose employment involved heavy manual labor or extensive driving, and those whose preinjection spine x-ray films indicated retrograde spondylolisthesis.

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.

Surgical experience following intervertebral discolysis with collagenase

1986 ◽  
Vol 64 (4) ◽  
pp. 613-616 ◽  
Author(s):  
Robert G. Fisher ◽  
John W. Bromley ◽  
George L. Becker ◽  
Mark Brown ◽  
Vert Mooney
Keyword(s):  
Surgical Intervention ◽  
Lumbar Disc ◽  
Enzyme Treatment ◽  
Surgical Experience ◽  
Disc Disease ◽  
Disc Space ◽  
Lumbar Disc Disease ◽  
Content Type ◽  
Space Infection ◽  
Herniated Lumbar Disc

✓ Of 410 patients with refractory herniated lumbar disc disease treated with intradiscal collagenase, 82 (20%) did not respond to enzyme treatment and subsequently underwent surgery. Failure to improve in 6 to 8 weeks was the predominant cause for surgical intervention (53 patients). Increased pain (18 patients), progressing neurological deficit (10 patients), and disc-space infection (one patient) were the other indications for surgery. At surgery, extrusions and/or sequestrations were found in 46 patients, undigested protrusions in 16 patients, and other causes of treatment failure in 14 patients. Six patients had normal findings. There was no evidence of adverse enzyme activity on the surrounding structures. Surgical results showed an overall success rate of 87%, and did not appear to be compromised by the previous enzyme therapy.

Chemonucleolysis with chymopapain: results in 150 patients

1987 ◽  
Vol 67 (2) ◽  
pp. 187-191 ◽  
Author(s):  
Christopher B. Shields ◽  
Steven J. Reiss ◽  
Henry D. Garretson
Keyword(s):  
Lumbar Disc ◽  
Third Party ◽  
Daily Activities ◽  
Mail Questionnaire ◽  
Disc Disease ◽  
Lumbar Disc Disease ◽  
Content Type ◽  
Cast Doubt ◽  
Mild Restriction

✓ Chemonucleolysis with chymopapain has been advocated for the treatment of lumbar disc disease. When polled by a mail questionnaire, 150 consecutive patients who had undergone chemonucleolysis reported an overall success rate of only 40% and a failure rate of 60%. However, 57% of the patients were active or had only mild restriction of daily activities. Of those patients employed prior to injection, only 63% had returned to work. Those with workmen's compensation benefits fared considerably worse than those covered by third-party insurance (17% vs. 51% success). These results cast doubt on the long-term benefits of chymopapain in the treatment of lumbar disc disease.

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.

scholarly journals Does the Intradiscal Injection of Platelet Rich Plasma Have Any Beneficial Role in the Management of Lumbar Disc Disease?

2021 ◽  
pp. 219256822199836
Author(s):  
Sathish Muthu ◽  
Madhan Jeyaraman ◽  
Girinivasan Chellamuthu ◽  
Naveen Jeyaraman ◽  
Rashmi Jain ◽  
...  
Keyword(s):  
Beneficial Effect ◽  
Platelet Rich Plasma ◽  
Lumbar Disc ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Significant Heterogeneity ◽  
Disc Disease ◽  
Lumbar Disc Disease ◽  
Beneficial Role ◽  
Sf 36

Study Design: Systematic review and meta-analysis. Objectives: We performed this meta-analysis to evaluate whether intradiscal Platelet Rich Plasma(PRP) injection has any beneficial role in the management of lumbar disc disease. Methods: We conducted independent and duplicate electronic database searches including PubMed, Embase, and Cochrane Library till September 2020 for studies investigating the role of intradiscal PRP in the management of lumbar disc disease. The analysis was performed in the R platform using OpenMeta[Analyst] software. Results: 13 studies including 2 RCTs, 5 prospective, and 6 retrospective studies involving 319 patients were included in the meta-analysis. A single-arm meta-analysis of the included studies showed a beneficial effect of the intervention in terms of pain relief outcomes like VAS score (p < 0.001), pain component of SF-36 (p = 0.003) while such improvement was not seen in functional outcome measures like ODI score (p = 0.071), the physical component of SF-36 (p = 0.130) with significant heterogeneity noted among the included studies. No structural improvement in magnetic resonance imaging was observed (p = 0.106). No additional procedure-related adverse events were noted in the included studies (p = 0.662). Conclusion: There is a paucity of high-quality studies to give conclusive evidence on the benefits of intradiscal PRP for lumbar disc disease. Although intradiscal PRP injection has shown some beneficial effect in controlling pain for lumbar disc disease, we could not find structural or functional improvement from the included studies. Hence, we recommend large double-blind double-arm randomized controlled studies to analyze the benefits of the intervention being analyzed.

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.

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