scholarly journals Most Common MRI finding in Lumbosacral Degenerative changes in Nepal Police

2021 ◽  
Vol 4 (1) ◽  
pp. 7-14
Author(s):  
Kedar Khadgi ◽  
Tanoj Bahadur Singh
Keyword(s):  
Degenerative Changes ◽  
Common Finding ◽  
Foraminal Stenosis ◽  
Disc Protrusion ◽  
Canal Stenosis ◽  
Lateral Recess Stenosis ◽  
Increasing Trend ◽  
Disc Bulge ◽  
Annular Tear ◽  
Disc Extrusion

Introduction: Low back pain (LBP) is a common problem that affects about two-thirds of adults sometimes in their life. Magnetic Resonance Imaging (MRI) with excellent tissue contrast is a better modality for assessing it. We aimed to assess the common findings overall, gender-wise and age-wise in lumbosacral degenerative changes in Nepal police personnel. Methods: The 54 Nepalese police with disc degeneration changes in the MRI report were included . The following MRI findings were evaluated: decrease disc height, disc desiccation change, diffuse disc bulge, asymmetrical disc bulge, disc protrusion, disc extrusion, annular tear, central spinal canal stenosis, foraminal stenosis, spinal nerve compromise, lumbar lordosis preserved or not, osteophyte and modic changes. Results: Mostly involved lumbosacral discs were L4-L5 and L5-S1 and the least involved lumbosacral disc was L1-L2. Disc desiccation changes were the most common finding observed. Disc desiccation changes, decreased disc height, lateral recess stenosis, foraminal stenosis was common in L5-S1. Diffuse disc bulge, asymmetric disc bulge, disc protrusion, annular tear, central spinal canal stenosis were common in L4-L5. Modic type II change was the commonest endplate change observed.. Lateral recess stenosis and foraminal stenosis showed an increasing trend with increment in age group. The most common finding in both gender was disc desiccation changes and diffuse disc bulge. However, disc protrusion, disc extrusion, and annular tear were more common in males and asymmetrical disc bulge in females. Conclusion: This study shows  L4-L5 and L5-S1 is the most common intervertebral disc involved in degeneration in Nepal police. Disc desiccation change and diffuse disc bulge are the most frequent finding irrespective of age and gender. Degenerative changes have an increasing trend with increasing age. Disc herniation is more common in male police individuals than female police individuals of Nepal.

Simplified Universal Grading of Lumbar Spine MRI Degenerative Findings: Inter-Reader Agreement of Non-Radiologist Spine Experts

Pain Medicine ◽  
2021 ◽  
Author(s):  
Nityanand Miskin ◽  
Zacharia Isaac ◽  
Yi Lu ◽  
Melvin C Makhni ◽  
Danielle L Sarno ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Spinal Stenosis ◽  
Degenerative Changes ◽  
Grading System ◽  
Foraminal Stenosis ◽  
Substantial Agreement ◽  
Lateral Recess ◽  
Lateral Recess Stenosis ◽  
Facet Arthropathy ◽  
Spine Mri

Abstract Objective 1) To describe a simplified multidisciplinary grading system for the most clinically relevant lumbar spine degenerative changes. 2) To measure the inter-reader variability among non-radiologist spine experts in their use of the classification system for interpretation of a consecutive series of lumbar spine magnetic resonance imaging (MRI) examinations. Methods ATS multidisciplinary and collaborative standardized grading of spinal stenosis, foraminal stenosis, lateral recess stenosis, and facet arthropathy was developed. Our institution’s picture archiving and communication system was searched for 50 consecutive patients who underwent non-contrast MRI of the lumbar spine for chronic back pain, radiculopathy, or symptoms of spinal stenosis. Three fellowship-trained spine subspecialists from neurosurgery, orthopedic surgery, and physiatry interpreted the 50 exams using the classification at the L4–L5 and L5–S1 levels. Inter-reader agreement was assessed with Cohen’s kappa coefficient. Results For spinal stenosis, the readers demonstrated substantial agreement (κ = 0.702). For foraminal stenosis and facet arthropathy, the three readers demonstrated moderate agreement (κ = 0.544, and 0.557, respectively). For lateral recess stenosis, there was fair agreement (κ = 0.323). Conclusions A simplified universal grading system of lumbar spine MRI degenerative findings is newly described. Use of this multidisciplinary grading system in the assessment of clinically relevant degenerative changes revealed moderate to substantial agreement among non-radiologist spine physicians. This standardized grading system could serve as a foundation for interdisciplinary communication.

scholarly journals Surekha Pai

2021 ◽  
Vol 7 (1) ◽  
pp. 5-8
Author(s):  
Surekha Pai ◽  
◽  
S Anjana ◽  
Keyword(s):  
Internal Medicine ◽  
Case Report ◽  
Lateral Compartment ◽  
Degenerative Changes ◽  
Low Back ◽  
Disc Protrusion ◽  
Tingling Sensation ◽  
One Year ◽  
Disc Extrusion

This is a case report of patient diagnosed as IVDP present with tingling sensation over anterior and lateral compartment of thigh followed by pain over low back region radiates up to right ankle since one year. MRI revealed degenerative changes and disc protrusion at L3-L4, L4-L5 and disc extrusion at L5-S1 levels. Clinically the patient was present with symptoms of vatika Gridhrasi explained in Ayurveda classics. The patient was managed with Katibasti with Sahacharadi taila (7 days) followed by Patrapotali sweda and Erandamuladi Niruha vasti (8 days) along with Sahacharadi kashaya internally (50 ml BD B/F) in first visit. Patient continued the internal medicine and after a gap of one month, she was administered same protocol with Rajayapana vasti on second visit. Two assessment were made after treatment using ODI. After second visit ODI changed from severe to moderate disability.

Prompt Return to Work after Bilateral Transforaminal Full-endoscopic Lateral Recess Decompression under Local Anesthesia: A Case Report

2020 ◽  
Author(s):  
Kosuke Sugiura ◽  
Kazuta Yamashita ◽  
Hiroaki Manabe ◽  
Yoshihiro Ishihama ◽  
Fumitake Tezuka ◽  
...  
Keyword(s):  
Return To Work ◽  
Local Anesthesia ◽  
Skin Incision ◽  
Leg Pain ◽  
Lateral Recess ◽  
Canal Stenosis ◽  
Transforaminal Approach ◽  
Lateral Recess Stenosis ◽  
Lumbar Spinal ◽  
Herniated Nucleus Pulposus

AbstractTransforaminal full-endoscopic lumbar diskectomy became established early in the 21st century. It can be performed under local anesthesia and requires only an 8-mm skin incision, making it the least invasive disk surgery method available. The full-endoscopic technique has recently been used to treat lumbar spinal canal stenosis. Here, we describe the outcome of simultaneous bilateral decompression of lumbar lateral recess stenosis via a transforaminal approach under local anesthesia in a 60-year-old man. The patient presented with a complaint of bilateral leg pain that was preventing him from standing and walking, and he had been able to continue his work as a dentist by treating patients while seated. Imaging studies revealed bilateral lumbar lateral recess stenosis with central herniated nucleus pulposus at L4/5. We performed simultaneous bilateral transforaminal full-endoscopic lumbar lateral recess decompression (TE-LRD) under local anesthesia. Both decompression and diskectomy were successfully completed without complications. Five days after TE-LRD, he was able to return to work, and 3 months after the surgery, he resumed playing golf. Full-endoscopic surgery under local anesthesia can be very effective in patients who need to return to work as soon as possible after surgery.

scholarly journals Detection of Degenerative Changes on MR Images of the Lumbar Spine with a Convolutional Neural Network: A Feasibility Study

Diagnostics ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. 902
Author(s):  
Nils Christian Lehnen ◽  
Robert Haase ◽  
Jennifer Faber ◽  
Theodor Rüber ◽  
Hartmut Vatter ◽  
...  
Keyword(s):  
Neural Network ◽  
Lumbar Spine ◽  
Diagnostic Accuracy ◽  
Nerve Root ◽  
Spinal Canal ◽  
Spinal Canal Stenosis ◽  
Degenerative Changes ◽  
High Diagnostic Accuracy ◽  
Canal Stenosis ◽  
Disc Herniations

Our objective was to evaluate the diagnostic performance of a convolutional neural network (CNN) trained on multiple MR imaging features of the lumbar spine, to detect a variety of different degenerative changes of the lumbar spine. One hundred and forty-six consecutive patients underwent routine clinical MRI of the lumbar spine including T2-weighted imaging and were retrospectively analyzed using a CNN for detection and labeling of vertebrae, disc segments, as well as presence of disc herniation, disc bulging, spinal canal stenosis, nerve root compression, and spondylolisthesis. The assessment of a radiologist served as the diagnostic reference standard. We assessed the CNN’s diagnostic accuracy and consistency using confusion matrices and McNemar’s test. In our data, 77 disc herniations (thereof 46 further classified as extrusions), 133 disc bulgings, 35 spinal canal stenoses, 59 nerve root compressions, and 20 segments with spondylolisthesis were present in a total of 888 lumbar spine segments. The CNN yielded a perfect accuracy score for intervertebral disc detection and labeling (100%), and moderate to high diagnostic accuracy for the detection of disc herniations (87%; 95% CI: 0.84, 0.89), extrusions (86%; 95% CI: 0.84, 0.89), bulgings (76%; 95% CI: 0.73, 0.78), spinal canal stenoses (98%; 95% CI: 0.97, 0.99), nerve root compressions (91%; 95% CI: 0.89, 0.92), and spondylolisthesis (87.61%; 95% CI: 85.26, 89.21), respectively. Our data suggest that automatic diagnosis of multiple different degenerative changes of the lumbar spine is feasible using a single comprehensive CNN. The CNN provides high diagnostic accuracy for intervertebral disc labeling and detection of clinically relevant degenerative changes such as spinal canal stenosis and disc extrusion of the lumbar spine.

scholarly journals Prevalence and breed predisposition for thoracolumbar intervertebral disc disease in cats

2016 ◽  
Vol 19 (4) ◽  
pp. 419-423 ◽  
Author(s):  
Steven De Decker ◽  
Anne-Sophie Warner ◽  
Holger A Volk
Keyword(s):  
Intervertebral Disc ◽  
General Hospital ◽  
Clinical Signs ◽  
Neurological Deficits ◽  
Intervertebral Disc Disease ◽  
Disc Disease ◽  
Disc Protrusion ◽  
Uncommon Condition ◽  
Hospital Population ◽  
Disc Extrusion

Objectives The objective was to evaluate the prevalence and possible breed predilections for thoracolumbar intervertebral disc disease (IVDD) in cats. Methods Medical records and imaging studies of cats diagnosed with thoracolumbar IVDD between January 2008 and August 2014 were retrospectively reviewed and compared with the general hospital population. The association between type of IVDD (ie, intervertebral disc extrusion [IVDE] or intervertebral disc protrusion [IVDP]) and breed, age, sex, and duration and severity of clinical signs was also evaluated. Results Of 12,900 cats presented during the study period, 31 (0.24%) were diagnosed with IVDD, including 17 purebred and 14 non-purebred cats. Of all presented purebred cats, 0.52% were diagnosed with thoracolumbar IVDD. More specifically, 1.29% of all British Shorthairs and 1.83% of all presented Persians were diagnosed with IVDD. Compared with the general hospital population, purebred cats ( P = 0.0001), British Shorthairs ( P <0.0001) and Persians ( P = 0.0006) were significantly overrepresented with thoracolumbar IVDD. Affected purebred cats were younger than affected non-purebred cats ( P = 0.02). Of 31 cats with IVDD, 19 were diagnosed with IVDE and 12 with IVDP. Cats with IVDE had a significantly shorter duration of clinical signs ( P = 0.0002) and demonstrated more severe neurological deficits ( P = 0.04) than cats with IVDP. Conclusions and relevance Although thoracolumbar IVDD is an uncommon condition in cats, purebred cats, British Shorthairs and Persians, were overrepresented. It is currently unclear if this represents a true breed predisposition or a higher likelihood of owners of purebred cats seeking referral for advanced diagnostic imaging procedures.

Misplacement of Stent Into Epidural Venous Plexus With Resultant Cauda Equina Syndrome and Open Surgical Treatment: A Case Report

2017 ◽  
Vol 15 (3) ◽  
pp. E23-E26 ◽  
Author(s):  
Benjamin B Whiting ◽  
Celene B Mulholland ◽  
Lorin Daniels ◽  
U Kumar Kakarla ◽  
Nicholas Theodore ◽  
...  
Keyword(s):  
Case Report ◽  
Endovascular Therapy ◽  
Spinal Canal ◽  
Cauda Equina Syndrome ◽  
Cauda Equina ◽  
Foraminal Stenosis ◽  
Venous Plexus ◽  
Invasive Treatment ◽  
Endovascular Stents ◽  
Canal Stenosis

Abstract BACKGROUND AND IMPORTANCE Endovascular therapy has proven to be a safe, minimally invasive treatment for multiple etiologies, but proper precautions must be taken to avoid complications. When complications occur, they should be promptly identified and corrected when possible. This case report describes endovascular stents misplaced into the epidural spinous venous plexus rather than the iliofemoral arteries, causing cauda equina syndrome, as well as the spinal procedure performed to treat the resulting spinal canal compression. CLINICAL PRESENTATION A 67-yr-old man had undergone what he thought was iliofemoral arterial stenting at an outside hospital for peripheral vascular disease. He presented 8 d later to our hospital with cauda equina syndrome comprising back pain, right L5 radiculopathy, perianal numbness, urinary retention, and constipation. Scans demonstrated stents deployed into the venous system, traversing the spinal canal and the right L5-S1 neural foramen, resulting in severe spinal canal stenosis, right L5-S1 foraminal stenosis, and moderate left S1-S2 foraminal stenosis. The patient underwent an L5-S1 laminectomy with full right L5-S1 facetectomy and left S1-S2 medial facetectomy, with associated L5-S1 posterolateral fusion with fixation to remove the stent and decompress the neural elements. CONCLUSION Although stent misplacement is an uncommon complication of endovascular therapy, this case demonstrates the importance of ensuring access to the proper vessel before stent placement. Once this complication was recognized, safe removal of the stents was possible and the patient demonstrated meaningful postoperative improvement in symptoms and strength.

Intermittent cauda equina compression due to narrow spinal canal

1972 ◽  
Vol 37 (1) ◽  
pp. 83-88 ◽  
Author(s):  
Hiroshi Yamada ◽  
Masaki Ohya ◽  
Tsuguo Okada ◽  
Zenji Shiozawa
Keyword(s):  
Spinal Canal ◽  
Ligamentum Flavum ◽  
Cauda Equina ◽  
Disc Protrusion ◽  
Complete Obstruction ◽  
Content Type ◽  
Canal Stenosis ◽  
Cauda Equina Compression ◽  
Narrow Spinal Canal ◽  
Lumbar Spinal

✓ Five patients with intermittent claudication due to compression of the cauda equina in the presence of lumbar spinal canal stenosis or midline intervertebral disc protrusion are described. The characteristic myelographic evidence was complete obstruction during extension of the spine and release of the block with flexion. The cause of this syndrome is considered to be intermittent bulging of the ligamentum flavum into a narrow spinal canal so as to compress the cauda equina during extension of the back.

Effectiveness of Cervical Hemilaminectomy in Canine Hansen Type I and Type II Disc Disease: A Retrospective Study

2011 ◽  
Vol 47 (5) ◽  
pp. 342-350 ◽  
Author(s):  
Oliver Schmied ◽  
Lorenzo Golini ◽  
Frank Steffen
Keyword(s):  
Medical Records ◽  
Cervical Vertebrae ◽  
Clinical Signs ◽  
Type I ◽  
Type Ii ◽  
Disc Disease ◽  
Disc Protrusion ◽  
Common Clinical Presentation ◽  
Disc Extrusion ◽  
Small Breed

Medical records of 41 dogs, including 15 small breed dogs (&lt;15 kg) and 26 large breed dogs (&gt;15 kg), with cervical intervertebral disc disease (IVDD) that underwent a hemilaminectomy were reviewed. Dogs were diagnosed using myelography, computed tomography/myelography, or MRI, and dogs were classified as having either Hansen Type I disc extrusion or Hansen Type II disc protrusion located ventrally, ventrolaterally, or laterally within the cervical spinal canal. The most common clinical presentation was ambulatory tetraparesis and/or lameness (44%). The most affected sites for cervical IVDD were between the sixth and seventh cervical vertebrae (C6–C7; 78% of Hansen Type II discs) and C2–C3 (86% of Hansen Type I discs). Treatment was effective in 88% of dogs. Five large breed dogs (12%) did not improve. In dogs with a Hansen Type I disc extrusion, clinical signs improved in 96% of the cases. In dogs with a Hansen Type II disc protrusion, an excellent and good outcome was seen in 47% and 32% of cases, respectively. Outcome was significantly better for small breed dogs and dogs with Hansen Type I disc disease compared with large breed dogs and dogs with Hansen Type II disc disease.

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