scholarly journals A rare case of L5-S1 right severe foraminal stenosis and paramedian disc herniation result in foot drop of right lower extremity: A case report

2021 ◽  
Vol 8 (10) ◽  
pp. 623-627
Author(s):  
Ngoc Quyen Nguyen ◽  
Trong Hau Phan
Keyword(s):  
Lower Extremity ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Rare Case ◽  
Lumbar Disc ◽  
Clinical Manifestations ◽  
Foot Drop ◽  
Foraminal Stenosis ◽  
Mri Findings ◽  
The Right

Objective: the authors presented a extremely rare case of severe foraminal stenosis combined with huge lateral lumbar disc herniation  Case presentation: The authors presented a 74 – year old, male with type II chronic diabetes, had severe pain of the dermatomal distribution of L5, S1 nerve roots, and foot-drop of the right lower limb. When we evaluated the patient’s MRI, the huge paramedian disc herniation of the right L5-S1 level was seen and the right L5-S1 laminotomy and discetomy were planned for the treatment of the patient. However, the clinical symptoms were not completely correlated with that MRI findings so that, we re-checked the MRI, particularly at the lumbosacral region, and the right severe foraminal stenosis of L5-S1 level was found. The patient underwent surgery with facetectomy, transforaminal interbody fusion, and pedicle screw fixation. After the operation, the patient has quickly reduced radiating pain of the right lower extremity, although the foot-drop was not improved. Because of the huge lateral lumbar disc herniation impression, that could affect the assessing the patient’s injury correctly, leaded consequences of a missing diagnosis of foraminal stenosis and inadequate surgery method. Conclusion: It is essential to detail examination of the clinical manifestations and thorough assessment of MRI for evaluation of the correlation between the physical examination and MRI findings before making the decision of surgical method.

scholarly journals The diagnostic pitfalls of lumbar disc herniation---- malignant sciatic nerve tumour: two case reports and literature review

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Li Zhao ◽  
Junqiang Wei ◽  
Chenguang Wan ◽  
Shuhong Han ◽  
He Sun
Keyword(s):  
Clinical Practice ◽  
Sciatic Nerve ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lower Limb ◽  
Lumbar Disc ◽  
Clinical Manifestations ◽  
B Cell Lymphoma ◽  
Malignant Tumours ◽  
The Right

Abstract Background Sciatica pain is a typical symptom of lumbar disc herniation (LDH), but some neurogenic and malignant tumours surrounding the sciatic nerve can also cause similar symptoms. These tumours are often misdiagnosed or even mistreated as LDH in clinical practice. Case presentation In our clinical practice, we found two patients with malignant tumours who were misdiagnosed with LDH. One patient complained of pain and numbness in the right lower limb. The primary diagnosis was LDH, and the patient underwent posterior lumbar interbody fusion surgery. After the operation, the symptoms were not alleviated. Then, diffuse large B-cell lymphoma involving the soft tissue and the sciatic nerve was identified. Another patient who manifested with radiating pain in the right lower limb was diagnosed with LDH at Chengde Central Hospital. He received regular conservative treatment for approximately 6 months, but his symptoms were not relieved, and then he was referred to our hospital. A malignant peripheral nerve sheath tumour (MPNST) of the sciatic nerve was diagnosed, and he received cisplatin (DDP) chemohyperthermia. Conclusions Descriptions of tumour lesions involving the sciatic nerve and misdiagnosed as LDH in the literature are rare. In the reported literature, 7 patients were misdiagnosed with LDH, and all patients presented with sciatica. Among them, 4 patients only received surgical treatment, 1 patient only underwent neurolysis, and 2 patients received both surgical and chemotherapy treatment. Their low incidence and similar clinical manifestations to LDH make malignant tumours involving the sciatic nerve easy to misdiagnose. When the clinical symptoms and signs are inconsistent with the imaging findings, we need to be aware of non-discogenic sciatica, including tumours involving the sciatic nerve. Furthermore, tumours that grow near the exit of the sciatic notch may be misdiagnosed because of their deeper location and because they are covered with gluteal muscles. Sometimes sciatica caused by sciatic nerve tumours is only distal, without any radicular distribution. This pain is more severe than that caused by LDH, and this pain is not related to the position of the lumbar spine. Thus, it is beneficial to perform a detailed physical examination of the sciatic nerve to avoid this kind of misdiagnosis.

Clinical Manifestations and MRI Findings of Patients With Hydrated and Dehydrated Lumbar Disc Herniation

2006 ◽  
Vol 13 (12) ◽  
pp. 1485-1489 ◽  
Author(s):  
Alireza Rasekhi ◽  
Abdolrahman Babaahmadi ◽  
Reza Assadsangabi ◽  
Seyyed Ali Nabavizadeh
Keyword(s):  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Clinical Manifestations ◽  
Mri Findings

scholarly journals Pattern of Neurological Improvements in Patient with Lumbar Disc Herniation after Microdiscectomy: Experience at the Fourth Oldest Western Medical Facility in South Asia

2017 ◽  
Vol 14 (2) ◽  
pp. 8-15
Author(s):  
Kiran Niraula ◽  
Muhammad Irfan ◽  
Chandra P Limbu ◽  
Raj Kumar KC ◽  
Muhammad A Shaheen ◽  
...  
Keyword(s):  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Muscle Power ◽  
Lumbar Disc ◽  
Sampling Technique ◽  
Neurological Status ◽  
T Test ◽  
Mri Findings ◽  
Chi Square ◽  
Paired T Test

The pattern of improvement in Neurological status after disc surgery is different. The chronology of improvement in Medical Research Council (MRC) scores, sensory status and improvement in Straight Leg Raise (SLR) test degrees is beneficial in management part to surgeons, relatives and the patients.To assess pattern of neurological outcomes in patients with lumbar disc herniation after microdiscectomy in terms of muscle power, sensory status and SLR.A Quasi experimental study comprising 70 consecutive cases though non-probability purposive sampling technique of both the sexes admitted in Neurosurgery department, Mayo Hospital operated for the 1st time for any disc pathology with no other spinal lesions giving consent themselves or though legal guardians was conducted. Pain for leg and back was measured pre and post-operatively was done by VAS which had 42 days of follow up. Standard Neurological examinations were conducted pertaining to muscle power (by MRC), sensory status and SLR test pre and post-operatively. Variables according to their nature were expressed in the form of Mean±SD, Median (Range) and Frequency (percentage). Mc Neumer’s chi square test and paired t test were used to see association between preoperative and post-operative Neurological status depending on their nature viz: qualitative or quantitative respectively in SPSS version 15.Out of 70 patients 74% were male and 26% were females. Mean±SD of patients was 37.6±13.0 years. Majority were Laborers after housewives. Illiterates, Poor lifting techniques were the most common characteristics in the respective headings of education and employment. Most common level of disc herniation was L4-L5, L5- S1 level (96%) where Prolapse and extrusion were most common MRI findings. As compared to pre-operative (3.4) muscle power 1st and 42nd day power were respectively 4.0 and 4.7 (p=0.001). Pre-operatively only 32 (45.7%) had normal sensation which improved to 38 (54.3%) and 51 (72.9%) respectively in 1st and 42nd day of surgery (p=0.001). Pre-operative mean SLR improved to 98.6 degrees in 1st POD and continued to be the same till 42nd day (p=0.001). All the MRC findings, sensory status and SLR values in each post-operative days were statistically significant with the baseline by paired t test (p=0.001). MRC and Sensory status had same pattern of improvement (r=0.0. p=0.04) unlike SLR which total improvements were see in 1st POD itself.In conclusion, muscle power and sensory improvement follows same improvement pattern whereas maximum SLR improves in the 1st POD itself.Nepal Journal of Neuroscience, Vol. 14, No. 2, 2017 Page: 8-15

scholarly journals The relationship of the shear wave elastography findings of patients with unilateral lumbar disc herniation and clinical characteristics

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Qingyuan Wang ◽  
Hao Zhang ◽  
Jinxin Zhang ◽  
Hanqi Zhang ◽  
Hui Zheng
Keyword(s):  
Sciatic Nerve ◽  
Shear Wave ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Clinical Characteristics ◽  
Lumbar Disc ◽  
Shear Wave Elastography ◽  
Control Group ◽  
Symptom Duration ◽  
Foraminal Stenosis

Abstract Background The aim of this study was to find out whether the shear wave elastography (SWE) findings of patients with unilateral lumbar disc herniation (LDH) were related to clinical characteristics. Methods For this purpose, the study group included patients (N = 20; 13 male, 7 female) with complaints of unilateral sciatica, with foraminal stenosis caused by one level of LDH (L4-L5 or L5-S1). An gender-and age-matched control group (N = 27; 16 male, 11 female) was included. All the patients were examined on both the axial and longitudinal planes bilaterally at the same level using a convex array probe (1- 6 MHz, Supersonic Imagine, Aix en Provence, France). Results The sciatic nerve stiffness measured on longitudinal planes of the affected side was significantly higher than unaffected side (p < 0.001) and the control group (P < 0.05). Furthermore, the symptom duration of unilateral LDH is positively correlated with the stiffness the sciatic nerve (r = 0.52, p = 0.019). Conclusion According to these findings, ultrasound imaging can be considered as a useful tool to detect changes in the sciatic nerve due to disc herniation. This technique will have a promising prospect for many patients with unilateral LDH in monitoring stiffness during rehabilitation and before or after surgery.

scholarly journals The Association Between Preoperative MRI Findings and Surgical Revision Within Three Years After Surgery for Lumbar Disc Herniation

Spine ◽  
2019 ◽  
Vol 44 (11) ◽  
pp. 818-825
Author(s):  
Dorthe Schoeler Ziegler ◽  
Leah Carreon ◽  
Mikkel Oesterheden Andersen ◽  
Rikke Krüger Jensen
Keyword(s):  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Surgical Revision ◽  
Mri Findings

scholarly journals A Rare Case of Brucella Spondylodiscitis Mimicking Lumbar Disc Herniation

2016 ◽  
Vol 5 (1) ◽  
pp. 271
Author(s):  
Ergenekon Karagoz ◽  
Asim Ulcay ◽  
Hakan Simsek ◽  
Vedat Turhan ◽  
Hakan Erdem ◽  
...  
Keyword(s):  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Rare Case ◽  
Lumbar Disc

scholarly journals Comparison of the histopathological differences between the spinal material and posterior longitudinal ligament in patients with lumbar disc herniation: A focus on the etiopathogenesis

2021 ◽  
Vol 41 (2) ◽  
pp. 115-120
Author(s):  
Asuman Kilitci ◽  
Ziya Asan ◽  
Abdulbaki Yuceer ◽  
Omer Aykanat ◽  
Fatih Durna
Keyword(s):  
Disc Degeneration ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Posterior Longitudinal Ligament ◽  
Small Sample ◽  
Histopathological Changes ◽  
Surgical Operation ◽  
Mri Findings ◽  
Disc Material

BACKGROUND: Lumbar disc herniation (LDH) occurs owing to the inability of the posterior longitudinal ligament (PLL) to preserve the disc material within the intervertebral space. There is apparently no study that has investigated the histopathological changes occurring in both PLL and disc material in patients with LDH. OBJECTIVE: Investigate and compare the histopathological changes occurring in PLL and disc material of the patients who underwent a surgical operation for LDH. DESIGN: Descriptive, cross-sectional. SETTING: Pathology and neurosurgery departments of a tertiary health care institution PATIENTS AND METHODS: The study included patients who underwent surgical operation for LDH from January 2018 to May 2019 and whose PLL and disc material were removed together, and had disc degeneration findings that were radiologically and histologically concordant. MAIN OUTCOME MEASURES: PLL degeneration scores according to the histopathological findings, changes in disc materials according to the MRI findings, disc degeneration scores according to the histo-pathological findings. SAMPLE SIZE: 50. RESULTS: MRI and histological examinations showed fully degenerated black discs (Grade 2) in 12 patients, partially degenerated discs (Grade 1) in 29 patients and fresh/acute discs (Grade 0) in 9 patients. The PLL showed grade 0 degeneration in 2 patients, grade 1 degeneration in 23 patients, and grade 2 degeneration in 25 patients. PLL degeneration grades were higher than the disc degeneration grades ( P =.002). CONCLUSION: Longitudinal ligament degeneration can play a significant role in the pathogenesis of LDH. To the best of our knowledge, this study represents the first to focus on the histopathological changes occurring in both the PLL and disc material in patients with LDH. LIMITATIONS: Small sample, retrospective CONFLICT OF INTEREST: None.

Sign in / Sign up

Export Citation Format

Share Document