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.

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.

Acute herniated nucleus pulposus with cauda equina compression syndrome following chemonucleolysis

1987 ◽  
Vol 66 (4) ◽  
pp. 614-617 ◽  
Author(s):  
Samuel Smith ◽  
Lyal G. Leibrock ◽  
Benjamin R. Gelber ◽  
Eric W. Pierson
Keyword(s):  
Nucleus Pulposus ◽  
Disc Herniation ◽  
Therapeutic Intervention ◽  
Cauda Equina ◽  
Neurological Deficits ◽  
Content Type ◽  
Compression Syndrome ◽  
Cauda Equina Compression ◽  
Herniated Nucleus Pulposus ◽  
Fine Print

✓ Three cases of acute disc herniation causing cauda equina compression syndrome after chemonucleolysis are described. All three patients had myelographic blocks and, despite emergency decompression procedures, were left with residual neurological deficits. Recommendations are made regarding evaluation and therapeutic intervention, and possible etiologies of this problem are reviewed.

Effects of vertebral axial decompression on intradiscal pressure

1994 ◽  
Vol 81 (3) ◽  
pp. 350-353 ◽  
Author(s):  
Gustavo Ramos ◽  
William Martin
Keyword(s):  
Nucleus Pulposus ◽  
Pressure Measurement ◽  
Resting State ◽  
Pressure Transducer ◽  
Inverse Relationship ◽  
Intradiscal Pressure ◽  
Disc Space ◽  
Content Type ◽  
Applied Tension ◽  
Fine Print

✓ The object of this study was to examine the effect of vertebral axial decompression on pressure in the nucleus pulposus of lumbar discs. Intradiscal pressure measurement was performed by connecting a cannula inserted into the patient's L4-5 disc space to a pressure transducer. The patient was placed in a prone position on a VAX-D therapeutic table and the tensionometer on the table was attached via a pelvic harness. Changes in intradiscal pressure were recorded at resting state and while controlled tension was applied by the equipment to the pelvic harness. Intradiscal pressure demonstrated an inverse relationship to the tension applied. Tension in the upper range was observed to decompress the nucleus pulposus significantly, to below −100 mm Hg.

Direct percutaneous cerebral angiography in neurosurgical practice

1980 ◽  
Vol 52 (4) ◽  
pp. 525-528 ◽  
Author(s):  
Jerry Bauer ◽  
Jose Luis Salazar ◽  
Oscar Sugar ◽  
Ronald P. Pawl
Keyword(s):  
High Risk ◽  
Cerebrovascular Disease ◽  
Cerebral Angiography ◽  
Complication Rate ◽  
High Risk Population ◽  
Content Type ◽  
Pros And Cons ◽  
Sixth Decade ◽  
Symptoms And Signs ◽  
Fine Print

✓ A retrospective analysis of 1171 consecutive percutaneous retrograde brachial and carotid cerebral angiograms was performed on 635 patients, 50.7% of whom were in the sixth decade or older. Symptoms and signs of cerebrovascular disease were the most frequently investigated and diagnosed, accounting for 46.7% of all the angiograms. Despite this relatively high-risk population, we have found direct percutaneous cerebral angiography to have a very low risk. The pros and cons of direct percutaneous versus transfemoral cerebral angiography are discussed. The literature of the previous 10 years is reviewed, and the complication rate of these two techniques is compared.

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.

Posterolateral microdiscectomy for cervical monoradiculopathy caused by posterolateral soft cervical disc sequestration

1990 ◽  
Vol 72 (3) ◽  
pp. 370-377 ◽  
Author(s):  
Francois Aldrich
Keyword(s):  
Anterior Approach ◽  
Posterior Longitudinal Ligament ◽  
Clinical Results ◽  
Skin Incision ◽  
Posterolateral Approach ◽  
Cervical Disc ◽  
Attractive Alternative ◽  
Disc Space ◽  
Content Type ◽  
Fine Print

✓ The controversy over whether to use a posterior or anterior approach for surgical treatment of soft cervical discs is still largely unsettled. However, although the posterior approach may be underutilized, it has distinct advantages when there are specific indications. Out of a large pool of cases, 53 patients presented with acute monoradiculopathy caused by soft cervical disc herniation. In 36 of these, the disc was sequestered (nonconfined) and was posterolateral to the disc space as seen on computerized tomography-myelography. Distinct motor weakness was a common clinical finding in all 36 cases. These patients were treated by using a 2- to 3-cm skin incision for the posterolateral microsurgical approach. The extent of the lateral facetectomy depended upon the relationship between the nerve root and the disc. All fragments were lateral to the dural sac and were sequestered through the anulus fibrosus and the posterior longitudinal ligament. Sequestrations were removed under direct microscopic vision, but the disc space was not entered. Pain relief and motor-power improvement in the affected radicular distribution were immediate in all patients. Sensory deficit and residual motor loss improved dramatically with normalization at approximately 6 months. No complications occurred and the mean hospital stay was 2 days. The follow-up period varied from 4 to 42 months with a mean of 26 months. Thus far, there have been no recurrences or other associated complications. By using strict selection criteria and a microsurgical posterolateral approach with removal of the sequestered disc fragment, excellent results with normalization of the monoradiculopathy can be obtained. The ease of this technique, low risk, minimal complications, and excellent results make it an attractive alternative to the anterior approach. The clinical presentations, specific indications, surgical technique, and clinical results are discussed; and a prototype of a small cervical self-retaining retractor is described.

An unusual complication of Dura Film as a dural substitute

1984 ◽  
Vol 60 (5) ◽  
pp. 1076-1079 ◽  
Author(s):  
Carlos M. Ongkiko ◽  
Jeffrey T. Keller ◽  
Frank H. Mayfield ◽  
Stewart B. Dunsker
Keyword(s):  
Acute Subdural Hematoma ◽  
Unusual Complication ◽  
Graft Material ◽  
Review Of The Literature ◽  
Tumor Removal ◽  
Acute Hemorrhage ◽  
Content Type ◽  
Dural Substitute ◽  
Connective Tissue Capsule ◽  
Tissue Capsule

✓ Two cases are presented in which the patients developed an unusual complication following the use of an artificial dural substitute, silicone-coated Dacron (Dura Film). Both patients had undergone removal of a tumor and involved dura. The first patient developed a very thick connective-tissue capsule of the graft material which simulated a recurrent tumor. The second patient developed an acute hemorrhage initially thought to be an acute subdural hematoma beneath the artificial dura 9 weeks after tumor removal and implantation of the graft. A review of the literature and proposed mechanisms of these complications are presented.

Spinal intradural schwannoma without attachment to a nerve root

1982 ◽  
Vol 57 (5) ◽  
pp. 701-702 ◽  
Author(s):  
Angelo Bollati ◽  
Giuseppe Galli ◽  
Massimo Gandolfini ◽  
Giovanni Marini ◽  
Gabriele Pizzoli
Keyword(s):  
Nerve Root ◽  
Unusual Case ◽  
Content Type ◽  
Fine Print ◽  
Root Connection

✓ The authors report an unusual case of intradural schwannoma, without demonstrable nerve root connection. An original explanation is given.

Magnetic resonance imaging evaluation of adjacent segments after disc arthroplasty

2005 ◽  
Vol 3 (5) ◽  
pp. 342-347 ◽  
Author(s):  
Chris J. Neal ◽  
Michael K. Rosner ◽  
Timothy R. Kuklo
Keyword(s):  
Magnetic Resonance ◽  
Mr Imaging ◽  
Disc Replacement ◽  
Disc Space ◽  
Disc Arthroplasty ◽  
Content Type ◽  
Motion Segment ◽  
Adjacent Segments ◽  
Weighted Sequences ◽  
Fine Print

Object. Disc arthroplasty in the lumbar spine is an alternative to fusion when treating discogenic pain. Its theoretical benefits include preservation of the motion segment and the potential prevention of adjacent-segment degeneration. Despite the need to evaluate the benefit of preserving the adjacent segments after disc replacement, no study has been conducted to assess the ability of magnetic resonance (MR) imaging to depict the adjacent segments in patients who have undergone disc replacement surgery. Methods. Postoperative lumbar MR images were obtained in the first 10 patients in whom a metal-on-metal disc arthroplasty system was used to treat the L4–5 or L5—S1 levels. At the superior adjacent level, the superior endplate and disc space were demonstrated on 90% of the images on both T1-weighted fluid-attenuated inversion-recovery (FLAIR) and T2-weighted sequences despite the presence of artifacts. The inferior endplate at this level was documented on 70% of both T1-weighted FLAIR and T2-weighted sequences. At the level below the disc replacement in patients who underwent L4–5 surgery, the superior endplate was demonstrated on 66.7% of the T1-weighted FLAIR sequences but only 33.3% of the T2-weighted images. The disc space and inferior endplate were depicted on 66.7% of both T1-weighted FLAIR and T2-weighted sequences. Axial images revealed an artifact in every adjacent space except at the L5—S1 level. Conclusions. Based on the results of this pilot study, it appears that sagittal MR imaging can be undertaken to evaluate the adjacent motion segment for degenerative changes following total disc arthroplasty in most patients. This imaging modality will provide an additional measure to assess the long-term efficacy of this intervention compared with other treatment modalities and the natural history of lumbar disc degeneration.

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.

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