Intervertebral disc space cyst simulating a recurrent herniated nucleus pulposus

1988 ◽  
Vol 69 (1) ◽  
pp. 137-139 ◽  
Author(s):  
Jordan C. Grabel ◽  
Raphael Davis ◽  
Rosario Zappulla
Keyword(s):  
Intervertebral Disc ◽  
Preoperative Diagnosis ◽  
Relevant Literature ◽  
Radicular Pain ◽  
Lumbar Region ◽  
Intervertebral Disc Space ◽  
Disc Space ◽  
Content Type ◽  
Herniated Nucleus Pulposus ◽  
Fine Print

✓ The case presented is of a patient with an intervertebral disc space cyst producing recurrent radicular pain following microdiscectomy in the lumbar region. Difficulties with the preoperative diagnosis of this and other recurrent radicular syndromes are discussed, and a review of the relevant literature is presented.

Intervertebral bone implants following excision of protruded lumbar discs

1975 ◽  
Vol 42 (4) ◽  
pp. 401-405 ◽  
Author(s):  
Lee A. Christoferson ◽  
Bradford Selland
Keyword(s):  
Conservative Treatment ◽  
Intervertebral Disc ◽  
Lumbar Disc ◽  
Leg Pain ◽  
Intervertebral Disc Space ◽  
Disc Space ◽  
Disc Protrusion ◽  
Content Type ◽  
Back Surgery ◽  
Fine Print

✓ The authors describe a technique whereby a portion of the lamina removed during exposure of an intervertebral lumbar disc protrusion is implanted in the intervertebral disc space following disc excision. An analysis of 456 consecutive cases operated on by this technique and followed from 1 to 10 years is presented. Of the 418 patients followed, 92% indicated they were able to return to their normal activities and were satisfied with the result. Thirty percent of the patients indicated they had required some conservative treatment for recurrent episodes of back or leg pain. Ten patients had subsequent back surgery; only one implant has dislocated.

Chondroblastoma of the lumbar spine

2005 ◽  
Vol 2 (5) ◽  
pp. 596-600 ◽  
Author(s):  
Raphaël Vialle ◽  
Antoine Feydy ◽  
Ludovic Rillardon ◽  
Carla Tohme-Noun ◽  
Philippe Anract ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Local Recurrence ◽  
Osteolytic Lesion ◽  
Radicular Pain ◽  
Appendicular Skeleton ◽  
Lumbar Region ◽  
Content Type ◽  
Anterior Posterior ◽  
Fine Print

✓ Chondroblastoma is a benign cartilaginous neoplasm that generally affects the appendicular skeleton. Twenty-six cases of spinal chondroblastoma have been reported in the past 50 years, only six of which were located in the lumbar region. The authors report two cases involving this exceptional location. In both patients, low-back pain, in the absence of radicular pain, was the presenting symptom. In both cases, plain radiography and computerized tomography scanning revealed an osteolytic lesion surrounded by marginal sclerosis. Magnetic resonance imaging allowed the authors to study the tumor's local extension. Examination of a percutaneous fluoroscopy-guided biopsy sample revealed the following typical histological features of chondroblastoma: chondroid tissue, focally alternating with cellular areas, and no nuclear atypia or pleomorphism. To reduce the risk of local recurrence, vertebrectomy and anterior—posterior fusion were performed in both cases. In one case, a structural lumbar scoliosis was corrected during the posterior procedure. There was no postoperative complication. No recurrence was observed during the 3- to 6-year follow-up period. The surgery-related results were deemed successful. Although exceptional, the diagnosis of chondroblastoma is possible in lesions involving the lumbar spine. Other spinal locations are described in the literature, and frequency of recurrence is stressed. A vertebrectomy is advised to reduce the risk of local recurrence.

Outcome and prognostic factors in nonambulatory Hansen Type I intervertebral disc extrusions: 308 cases

2006 ◽  
Vol 19 (01) ◽  
pp. 29-34 ◽  
Author(s):  
D. A. Allen ◽  
E. R. Schertel ◽  
M. D. Barnhart ◽  
E. R. Wilson ◽  
J. A. Lineberger ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Intervertebral Disc ◽  
Motor Neuron ◽  
Lower Motor Neuron ◽  
Decompressive Surgery ◽  
Type I ◽  
Lumbar Region ◽  
Intervertebral Disc Space ◽  
Disc Space ◽  
Favourable Prognosis

SummaryThoracolumbar intervertebral disc disease is the most common cause of caudal paresis in dogs (1). Whilst the pathogenesis of the extrusion has been widely studied, treatment protocols and prognostic factors relating to outcome remain controversial. Recent studies have examined a multitude of factors relating to time to regain ambulation after decompressive surgery. Most intervertebral disc herniations occur in the thoracolumbar region, causing upper motor neuron signs in the rear limbs, which are thought to have a more favourable prognosis compared to the lower motor neuron signs created by herniation of an intervertebral disc in the caudal lumbar region. Due to the potential disruption of the lumbar intumescence, lower motor neuron signs have been reported as having a less favourable prognosis. The purpose of this study was to evaluate the intervertebral disc space as a prognostic factor relating to ambulatory outcome and time to ambulation after decompressive surgery. Hansen Type I intervertebral disc extrusions were studied in 308 non-ambulatory dogs. Preoperative and postoperative neurological status, corticosteroid use, signalment, intervertebral disc space, postoperative physical rehabilitation, previous hemilaminectomy surgery, disc fenestration, return to ambulation, and time to ambulation were reviewed.

Chymopapain treatment of intervertebral disc disease

1975 ◽  
Vol 42 (4) ◽  
pp. 374-383 ◽  
Author(s):  
Clark Watts ◽  
Robert Knighton ◽  
George Roulhac
Keyword(s):  
Intervertebral Disc ◽  
Proteolytic Enzyme ◽  
Intervertebral Disc Disease ◽  
Disc Disease ◽  
Disc Space ◽  
Content Type ◽  
Disc Material ◽  
Capillary Endothelial Cells ◽  
Fine Print ◽  
Rapid Conversion

✓ In the first of a two-part study, the authors review the known biochemical, pharmacological, toxicological, and experimental data concerning chymopapain and the intervertebral disc. They describe the action of this proteolytic enzyme, which apparently disrupts the protein mucopolysaccharide component of disc material, most marked in the nucleus pulposus. A rapid conversion to collagen causes a loss of disc space height; toxicity appears to result from alteration of bonding between capillary endothelial cells that in turn produces hemorrhage. Part 2 reviews significant reported results and complications of clinical chemonucleolysis.

Perforation of the anterior annulus during lumbar discectomy

1973 ◽  
Vol 38 (4) ◽  
pp. 514-515 ◽  
Author(s):  
William A. Shevlin ◽  
Alfred J. Luessenhop ◽  
John L. Fox ◽  
David C. McCullough
Keyword(s):  
Intervertebral Disc ◽  
Vascular Injury ◽  
Lumbar Discectomy ◽  
Anterior Longitudinal Ligament ◽  
Disc Space ◽  
Lumbar Intervertebral Disc ◽  
Content Type ◽  
Reliable Sign ◽  
Fine Print

✓ A case of retroperitoneal vascular injury during removal of a lumbar intervertebral disc is presented. It is proposed that the rapid escape of irrigating saline through the disc space may serve as a reliable sign of surgical perforation of the anterior annulus and anterior longitudinal ligament prior to the appearance of other signs of vascular injury.

Nerve root compression by herniated intradiscal gas

1990 ◽  
Vol 72 (2) ◽  
pp. 282-284 ◽  
Author(s):  
Gregory F. Ricca ◽  
James T. Robertson ◽  
Robert S. Hines
Keyword(s):  
Nucleus Pulposus ◽  
Nerve Root ◽  
Intervertebral Disc Degeneration ◽  
Disc Space ◽  
Content Type ◽  
Connective Tissue Capsule ◽  
Symptoms And Signs ◽  
Herniated Nucleus Pulposus ◽  
Tissue Capsule ◽  
Fine Print

✓ Intervertebral disc degeneration of any etiology may be associated with the formation of spaces or clefts within the disc. Gas collects within these spaces and can be seen roentgenographically. A case is presented in which intradiscal gas herniated into a connective tissue capsule, displacing the left S-1 nerve root and producing symptoms and signs identical to those of a herniated nucleus pulposus. The pathophysiology of gas within a disc space and the possibility that it may herniate much like the nucleus pulposus is discussed.

Peripheral nerve injury by chymopapain injection

1984 ◽  
Vol 61 (1) ◽  
pp. 1-8 ◽  
Author(s):  
Susan E. Mackinnon ◽  
Alan R. Hudson ◽  
Faustino Llamas ◽  
A. Lee Dellon ◽  
David G. Kline ◽  
...  
Keyword(s):  
Peripheral Nerve ◽  
Nerve Fiber ◽  
Peripheral Nerve Injury ◽  
Neurotoxic Effect ◽  
Disc Disease ◽  
Intervertebral Disc Space ◽  
Disc Space ◽  
Content Type ◽  
Fiber Damage ◽  
Fine Print

✓ Chymopapain injected into the intervertebral disc space (chemonucleolysis) has been used clinically in patients with disc disease with success. Neurosurgical complications secondary to the procedure have, however, been reported. In this study, the authors have investigated the possible neurotoxic effect of chymopapain on the peripheral nerve in rat and primate models. While the extrafascicular injection caused no nerve fiber damage, the intrafascicular injection caused dose-related nerve fiber damage in both species.

Percutaneous automated discectomy: a new method for lumbar disc removal

1987 ◽  
Vol 66 (1) ◽  
pp. 143-146 ◽  
Author(s):  
Joseph C. Maroon ◽  
Gary Onik
Keyword(s):  
Lumbar Disc ◽  
Surgical Excision ◽  
Radicular Pain ◽  
Disc Space ◽  
Content Type ◽  
A New Technique ◽  
Herniated Discs ◽  
Fine Print

✓ A new technique for percutaneous lumbar disc removal is described. The specially designed 2-mm blunt-tipped suction/cutting probe (nucleotome) is similar to the automated vitrectomy instrumentation used by ophthalmic surgeons. The procedure is performed under local anesthesia, with the patient in the prone position and with fluoroscopic guidance. The nucleotome is inserted into the appropriate disc space with specially designed instrumentation, guided by landmarks similar to those used in needle placement for chemonucleolysis. The technique has been evaluated in 20 patients with herniated discs (one at the L3-4 level and 19 at the L4-5 level) confirmed by myelography and/or computerized tomography scans after all conservative therapy for primarily radicular pain had failed. From 1 to 7 gm of disc material was removed in an average total operative time of approximately 1 hour. Eighty percent of the patients had good to excellent results in a short-term follow-up period of 6 months. Four patients subsequently required standard surgical excision of free disc fragments. No significant complications occurred. The procedure is contraindicated in patients with extruded or free fragments of disc in the spinal canal or in patients with herniations at the L5-S1 level pending development of additional instrumentation for insertion at that level. More extensive long-term studies are needed to further evaluate this procedure.

Neural connection between the ventral portion of the lumbar intervertebral disc and the groin skin

1996 ◽  
Vol 85 (2) ◽  
pp. 323-328 ◽  
Author(s):  
Yuzuru Takahashi ◽  
Tatsuo Morinaga ◽  
Shin-Ichiro Nakamura ◽  
Kaoru Suseki ◽  
Kazuhisa Takahashi ◽  
...  
Keyword(s):  
Intervertebral Disc ◽  
Groin Pain ◽  
Referred Pain ◽  
Blue Dye ◽  
Intervertebral Disc Space ◽  
Lumbar Intervertebral Disc ◽  
Axon Reflex ◽  
Content Type ◽  
C Fibers ◽  
Fine Print

✓ This study was designed to investigate neural mechanisms of referred pain in lumbar intervertebral disc lesions. Patients with a degenerative disc in lower lumbar segments occasionally complain of groin pain, which cannot be explained anatomically as having a radicular origin. In rats pretreated with intravenous application of Evans blue dye, the dye extravasation appeared in the groin skin after application of capsaicin to the ventral portion of the L5–6 intervertebral disc. This response occurred even in rats with a sectioned L-5 spinal nerve and sympathetic trunks, but did not occur in rats with a sectioned genitofemoral nerve. Capsaicin topically applied to the sciatic nerve did not cause dye extravasation in the hindpaw. Therefore, groin dye extravasation was not due to a direct effect of capsaicin but, rather, presumably was caused by an “antidromic axon reflex” of dichotomizing C fibers or to a segmental sympathetic reflex causing vascular permeability. The present results indicate that the ventral portion of the lumbar discs is neurally connected to the groin skin via the upper (L-2) lumbar spinal nerves in rats. Groin pain coincident with low-back pain may be explained as referred pain, indicating that a lesion is present in the ventral portion of the lumbar intervertebral disc space.

Radicular pain caused by synovial cyst: an underdiagnosed entity in the elderly?

2000 ◽  
Vol 92 (1) ◽  
pp. 57-60 ◽  
Author(s):  
Dhany R. Charest ◽  
Brendan G. Kenny
Keyword(s):  
Preoperative Diagnosis ◽  
World Literature ◽  
The Elderly ◽  
Synovial Cyst ◽  
Radicular Pain ◽  
Age Group ◽  
Content Type ◽  
The World ◽  
Synovial Cysts ◽  
Fine Print

Object. Synovial cyst is a recognized but infrequent cause of nerve root or spinal canal compression. The authors undertook a review of 839 decompressive spinal procedures performed over a 5-year period. They found seven cases in which the symptoms were caused by synovial cysts. Methods. Six of these cases were in a subgroup of 80 patients who were older than 60 years of age, which represents 7.5% of the total for this age group. More than 200 cases of this abnormality have been reported in the world literature, but the incidence, prevalence, and natural history remain unknown. Conclusions. The authors propose that the incidence of synovial cysts may be more common than recognized in the elderly and suggest that preoperative diagnosis may help limit the extent of the surgical approach.

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