Unilateral removal of pars interarticularis

2005 ◽  
Vol 2 (3) ◽  
pp. 279-288 ◽  
Author(s):  
Gabriel C. Tender ◽  
Richard V. Baratta ◽  
Rand M. Voorhies
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Short Form ◽  
Mcgill Pain Questionnaire ◽  
Foraminal Stenosis ◽  
Low Back ◽  
Content Type ◽  
Pars Interarticularis ◽  
Disc Herniations ◽  
Fine Print

Object. Lumbar radiculopathy secondary to foraminal entrapment can be treated by unilateral removal of the overlying pars interarticularis. The authors prospectively evaluated the outcome after this procedure. Methods. Thirty-six consecutive patients underwent unilateral resection of the pars interarticularis between August 1999 and July 2002. In 18 patients acute foraminal disc herniations compressed the nerve root against the superior pedicle; in the other 18 foraminal stenosis was secondary to degenerative changes. All patients, at each visit, completed the following questionnaires: visual analog scale for overall, leg, and back pain; the Prolo Functional Economic Rating scale; and the Pain Rating Index (PRI) of the Short-Form McGill Pain Questionnaire. At 1 year, leg pain improved in 33 patients (91%). Low-back pain appeared or worsened in eight patients (22%; one in the acute herniation group and seven in the chronic degenerative group). Only one patient required lumbar fusion for pain. The Prolo economic and function scores improved in 21 (58%) and 27 (75%) patients, respectively. The PRI scores improved in 30 cases (83%). No spondylolisthesis was observed at any level at which resection had been performed. Conclusions. Unilateral removal of the pars interarticularis is effective in relieving lumbar radicular symptoms in patients with intraforaminal entrapment. The incidence of low-back pain in patients with acute foraminal disc herniations does not increase as a result of this procedure. In patients with degenerative foraminal stenosis, unilateral resection of the pars interarticularis may be a better alternative to facetectomy and segmental fusion. This procedure may be a useful tool in spine surgery.

Percutaneous endoscopic discectomy: surgical technique and preliminary results compared to microsurgical discectomy

1993 ◽  
Vol 78 (2) ◽  
pp. 216-225 ◽  
Author(s):  
H. Michael Mayer ◽  
Mario Brock
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Lumbar Disc ◽  
Motor Deficits ◽  
Low Back ◽  
Content Type ◽  
Sensory Deficits ◽  
Endoscopic Discectomy ◽  
Disc Herniations ◽  
Fine Print

✓ Percutaneous endoscopic discectomy is a new technique for removing “contained” lumbar disc herniations (those in which the outer border of the anulus fibrosus is intact) and small “noncontained” lumbar disc herniations (those at the level of the disc space and occupying less than one-third of the sagittal diameter of the spinal canal) through a posterolateral approach with the aid of specially developed instruments. The technique combines rigid straight, angled, and flexible forceps with automated high-power suction shaver and cutter systems. Access can thus be gained to the dorsal parts of the intervertebral space where the disc herniation is located. Percutaneous endoscopic discectomy is monitored using an endoscope angled to 70° coupled with a television and video unit and is performed with the patient under local anesthesia and an anesthesiologist available if needed. Its indication is restricted to discogenic root compression with a minor neurological deficit. Two groups of patients with contained or small noncontained disc herniations were treated by either percutaneous endoscopic discectomy (20 cases) or microdiscectomy (20 cases). Both groups were investigated in a prospective randomized study in order to compare the efficacy of the two methods. The disc herniations were located at L2–3 (one patient), L3–4 (two patients), or L4–5 (37 patients). There were no significant differences between the two groups concerning age and sex distribution, preoperative evolution of complaints, prior conservative therapy, patient's occupation, preoperative disability, and clinical symptomatology. Two years after percutaneous endoscopic discectomy, sciatica had disappeared in 80% (16 of 20 patients), low-back pain in 47% (nine of 19 patients), sensory deficits in 92.3% (12 of 13 patients), and motor deficits in the one patient affected. Two years after microdiscectomy, sciatica had disappeared in 65% (13 of 20 patients), low-back pain in 25% (five of 20 patients), sensory deficits in 68.8% (11 of 16 patients), and motor deficits in all patients so affected. Only 72.2% of the patients in the microdiscectomy group had returned to their previous occupation versus 95% in the percutaneous endoscopic discectomy group. Percutaneous endoscopic discectomy appears to offer an alternative to microdiscectomy for patients with “contained” and small subligamentous lumbar disc herniations.

Dermoid tumors of the spinal cord

1970 ◽  
Vol 33 (6) ◽  
pp. 676-681 ◽  
Author(s):  
Ian C. Bailey
Keyword(s):  
Spinal Cord ◽  
Low Back Pain ◽  
Back Pain ◽  
Cauda Equina ◽  
Complete Removal ◽  
Cord Compression ◽  
Conus Medullaris ◽  
Low Back ◽  
Content Type ◽  
Fine Print

✓ This is an analysis of 10 cases of dermoid tumor occurring in the spinal canal (8 lumbar and 2 thoracic). Low-back pain was the commonest presenting symptom, especially if the tumor was adherent to the conus medullaris. Other complaints included urinary dysfunction and motor and sensory disturbances of the legs. Clinical and radiological evidence of spina bifida was found in about half of the cases and suggested the diagnosis of a developmental type of tumor when patients presented with progressive spinal cord compression. At operation, the tumors were often found embedded in the conus medullaris or firmly adherent to the cauda equina, thus precluding complete removal. Evacuation of the cystic contents, however, gave lasting relief of the low-back pain and did not cause any deterioration in neurological function. In a follow-up study, ranging from 1 to 15 years, virtually no improvement in the neurological signs was observed. On the other hand, only one case has deteriorated due to recurrence of tumor growth.

Nonsurgically managed patients with degenerative spondylolisthesis: a 10- to 18-year follow-up study

2000 ◽  
Vol 93 (2) ◽  
pp. 194-198 ◽  
Author(s):  
Shunji Matsunaga ◽  
Kosei Ijiri ◽  
Kyoji Hayashi
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Clinical Symptoms ◽  
Degenerative Spondylolisthesis ◽  
Low Back ◽  
Indications For Surgery ◽  
Initial Examination ◽  
Content Type ◽  
Fine Print

Object. Controversy exists concerning the indications for surgery and choice of surgical procedure for patients with degenerative spondylolisthesis. The goals of this study were to determine the clinical course of nonsurgically managed patients with degenerative spondylolisthesis as well as the indications for surgery. Methods. A total of 145 nonsurgically managed patients with degenerative spondylolisthesis were examined annually for a minimum of 10 years follow-up evaluation. Radiographic changes, changes in clinical symptoms, and functional prognosis were surveyed. Progressive spondylolisthesis was observed in 49 patients (34%). There was no correlation between changes in clinical symptoms and progression of spondylolisthesis. The intervertebral spaces of the slipped segments were decreased significantly in size during follow-up examination in patients in whom no progression was found. Low-back pain improved following a decrease in the total intervertebral space size. A total of 84 (76%) of 110 patients who had no neurological deficits at initial examination remained without neurological deficit after 10 years of follow up. Twenty-nine (83%) of the 35 patients who had neurological symptoms, such as intermittent claudication or vesicorectal disorder, at initial examination and refused surgery experienced neurological deterioration. The final prognosis for these patients was very poor. Conclusions. Low-back pain was improved by restabilization. Conservative treatment is useful for patients who have low-back pain with or without pain in the lower extremities. Surgical intervention is indicated for patients with neurological symptoms including intermittent claudication or vesicorectal disorder, provided that a good functional outcome can be achieved.

Syndromes associated with protrusion of upper lumbar intervertebral discs

1973 ◽  
Vol 38 (4) ◽  
pp. 499-503 ◽  
Author(s):  
Paul Gutterman ◽  
Henry A. Shenkin
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Intervertebral Discs ◽  
Thigh Pain ◽  
Low Back ◽  
Good Recovery ◽  
Content Type ◽  
Anterior Thigh ◽  
Acute Paraplegia ◽  
Fine Print

✓ This report reviews a series of 69 patients operated on for herniations of upper lumbar intervertebral discs and identifies four syndromes related to the principal complaint. These are, in order of frequency, anterior thigh pain, low-back pain only, sciatica, and acute paraplegia. Overall, 78% had satisfactory relief of pain and 93% were improved following laminectomy. Satisfactory results were more common with protrusions at L3–4 than at L2–3. Patients in whom the onset was sciatica had a higher percentage of satisfactory results (94%) than those with anterior thigh pain (70%) or low-back pain alone (80%). Neither of the patients with a paraplegic onset had a good recovery even after removal of the extruded disc.

Validation of the Short-Form McGill Pain Questionnaire-2 (SF-MPQ-2) in Acute Low Back Pain

2015 ◽  
Vol 16 (4) ◽  
pp. 357-366 ◽  
Author(s):  
Robert H. Dworkin ◽  
Dennis C. Turk ◽  
Jeremiah J. Trudeau ◽  
Carmela Benson ◽  
David M. Biondi ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Short Form ◽  
Mcgill Pain Questionnaire ◽  
Low Back ◽  
Pain Questionnaire ◽  
Acute Low Back Pain

scholarly journals Short-term effect of kinesiology taping on pain, functional disability and lumbar proprioception in individuals with nonspecific chronic low back pain: a double-blinded, randomized trial

2020 ◽  
Vol 28 (1) ◽  
Author(s):  
Soheila Abbasi ◽  
Mohammad-Reza Hadian Rasanani ◽  
Nastaran Ghotbi ◽  
Gholam Reza Olyaei ◽  
Ali Bozorgmehr ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Functional Disability ◽  
Short Form ◽  
Mcgill Pain Questionnaire ◽  
Low Back ◽  
Upright Standing ◽  
Double Blinded ◽  
Lumbar Proprioception

Abstract Background This study aimed to evaluate the effect of kinesiology taping (KT) on lumbar proprioception, pain, and functional disability in individuals with nonspecific chronic low back pain (CLBP). Methods Thirty individuals with nonspecific CLBP participated in this double-blinded, randomized clinical trial from July 2017 to September 2018. The participants were randomized into two groups: KT (n = 15) and placebo group (n = 15). KT was applied with 15–25% tension for 72 h, and placebo taping was used without tension. Lumbar repositioning error was measured by a bubble inclinometer at three different angles (45° and 60° flexion, and 15° extension) in upright standing. Pain and disability were assessed by the Short-Form McGill Pain Questionnaire and Oswestry Disability Index, respectively. All measurements were recorded at baseline and 3 days after taping. Results Pain and disability scores reduced 3 days after taping in the KT group with large effect sizes (p < 0.05). Only the total score of pain was significantly different between the groups 3 days after taping and improved more in the KT group with a large effect size (p < 0.05). However, lumbar repositioning errors were similar between the groups after 3 days (p > 0.05). Also, only constant error of 15° extension showed a moderate correlation with disability (r = 0.39, p = 0.02). Conclusion KT can decrease pain and disability scores after 3 days of application. Although placebo taping can reduce pain, the effect of KT is higher than placebo taping. The findings do not support the therapeutic effect of KT and placebo taping as a tool to enhance lumbar proprioception in patients with nonspecific CLBP. Trial registration The study prospectively registered on 21.05.2018 at the Iranian Registry of Clinical Trials: IRCT20090301001722N20.

scholarly journals The measurements of health-related quality-of-life and pain assessment in the preoperative patients with low back pain

Medicina ◽  
2009 ◽  
Vol 45 (2) ◽  
pp. 111 ◽  
Author(s):  
Kotryna Vereščiagina ◽  
Kazys Ambrozaitis ◽  
Bronius Špakauskas
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Quantitative Analysis ◽  
Disc Herniation ◽  
Pain Assessment ◽  
Short Form ◽  
Mcgill Pain Questionnaire ◽  
Low Back ◽  
Pain Questionnaire ◽  
Sf 36

Objective. This prospective observational study of the Short-Form Health Survey (SF-36), Oswestry Disability Index, Lithuanian version of the McGill Pain Questionnaire, and Visual Analogue Scale (VAS) for pain was performed to evaluate their effectiveness in the additional preoperative screening of patients with disc herniation disease. Patients and methods. In the present study, we investigated a cohort of 100 patients with lumbar disc herniation causing low back pain and the second one of 100 patients with nonspecific low back pain by applying physical activity, pain scales and Short-Form 36 General Health Questionnaire. Results. The quantitative analysis of SF-36 domain scores showed the substantial differences in both examined (herniated and control) groups. In the present study, we estimated moderate but statistically significant (P<0.05) correlations between the bodily pain domain scores and assessment of back and leg pain on the VAS, as well as between the physical function and walking/standing ability (Oswestry). According to appropriate pain assessment instruments (Lithuanian version of the McGill Pain Questionnaire), qualitative and quantitative analysis of the preoperative patients was performed. Conclusion. The provided methodology could be used in population-based studies or in clinical samples that focus on specific impairments and seek to control the pain frequency and intensity, for example, follow-up assessments testing the effectiveness of surgical procedures performed, and to elicit the pathways leading to other impairments.

Extradural lipomatosis simulating an acute herniated nucleus pulposus

1982 ◽  
Vol 57 (4) ◽  
pp. 559-562 ◽  
Author(s):  
Carol R. Archer ◽  
Kenneth R. Smith
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Acute Exacerbation ◽  
Signs And Symptoms ◽  
Low Back ◽  
Review Of The Literature ◽  
Content Type ◽  
History Of ◽  
Herniated Nucleus Pulposus ◽  
Fine Print

✓ A 48-year-old laborer presented with a 1-year history of low-back pain radiating into the posterior aspects of both thighs. Two weeks before admission, acute exacerbation resulted in signs and symptoms of compressive radiculopathy at L-5. Myelography revealed concentric constriction of the lower thecal sac due to abundant fat, as shown by computerized tomography. Laminectomy produced immediate relief of pain. The significance of these findings and a review of the literature are presented.

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