Unexpected cause of leg pain in a patient with lower back pain

Background: Conventional L5 corpectomy requires a large incision and an extended period of intraoperative fluoroscopy. We describe herein a new L5 corpectomy technique. Methods: A 79-year-old woman was referred to our hospital for leg pain and lower back pain due to an L5 vertebral fracture. Her daily life had been affected by severe lower back pain and sciatica for more than 2 months. We initially performed simple decompression surgery, but this proved effective for only 10 months. Results: For revision surgery, the patient underwent minimally invasive L5 corpectomy with a navigated expandable cage without fluoroscopy. The second surgery took 215 min, and estimated blood loss was 750 mL. The revision surgery proved successful, and the patient could then walk using a cane. In terms of clinical outcomes, the Oswestry Disability Index improved from 66% to 24%, and the visual analog scale score for lower back pain improved from 84 to 31 mm at the 1-year follow-up. Conclusions: Minimally invasive L5 corpectomy with a navigated expandable vertebral cage is effective for reducing cage misplacement and surgical invasiveness. With this new technique, surgeons and operating room staff can avoid the risk of adverse events due to intraoperative radiation exposure.

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Relief of Lower Back and Leg Pain after Myelography

The Open Orthopaedics Journal ◽

10.2174/1874325001610010539 ◽

2016 ◽

Vol 10 (1) ◽

pp. 539-542

Author(s):

Rui Guo ◽

Toshihiko Sakakibara ◽

Tetsutaro Mizuno ◽

Koji Akeda ◽

Tetsushi Kondo ◽

...

Keyword(s):

Back Pain ◽

Intermittent Claudication ◽

Lower Back Pain ◽

Adverse Reactions ◽

Leg Pain ◽

Mri Findings ◽

Spinal Disorder ◽

Lower Back ◽

Magnetic Resonance Imaging Mri ◽

Lumbar Spinal

Introduction: It is well-known that many patients will have adverse reactions such as headache and nausea after undergoing myelography, but we have often seen cases where symptoms such as lower back pain and leg pain were alleviated following myelography. To the best of our knowledge, such clinical cases of post-myelographic alleviation have not been reported. Materials and Methods: A total of 325 patients with a degenerative lumbar spinal disorder who underwent myelography were prospectively investigated at four hospitals from April 2012 to March 2014 to survey the post-myelographic alleviation of lower back and leg pain prospectively. The severities of lower back pain, leg pain and numbness of the lower extremities were evaluated and intermittent claudication distance was measured before myelography. The magnetic resonance imaging (MRI) findings and myelographic findings were also evaluated for the patients that their symptoms were improved. Results: Thirty-five of 325 cases (10.8%) of these patients had their symptoms alleviated after undergoing myelography; 26 cases of lower back pain, two cases of leg pain, two cases of numbness of the lower extremity, and five cases of intermittent claudication. Conclusion: In the patients of a degenerative lumbar spinal disorder, about 10% cases with lower back pain or intermittent claudication had post-myelographic alleviation. Intradural injection therapy might be a therapeutic method to alleviate these symptoms.

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Epiduroscopy as a Diagnostic Tool for the Lower Back Pain and/or Leg Pain

The Korean Journal of Pain ◽

10.3344/kjp.2016.29.3.151 ◽

2016 ◽

Vol 29 (3) ◽

pp. 151 ◽

Cited By ~ 2

Author(s):

Dae Hyun Jo

Keyword(s):

Back Pain ◽

Lower Back Pain ◽

Diagnostic Tool ◽

Leg Pain ◽

Lower Back

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The patient with lower back pain and leg pain with walking

Lumbar Spine Syndromes ◽

10.1007/978-3-7091-8981-8_9 ◽

1989 ◽

pp. 100-108

Author(s):

Gunnar B. J. Andersson ◽

Thomas W. McNeill

Keyword(s):

Back Pain ◽

Lower Back Pain ◽

Leg Pain ◽

Lower Back

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Reduction of Leg Pain by Oxiplex Gel After Lumbar Discectomy in Patients With Predominant Leg Pain and Elevated Levels of Lower Back Pain

Journal of Spinal Disorders & Techniques ◽

10.1097/bsd.0b013e3182a35590 ◽

2015 ◽

Vol 28 (8) ◽

pp. 301-307 ◽

Cited By ~ 1

Author(s):

Wei Lei ◽

Ronald J. Ehmsen ◽

Richard P. Chiacchierini ◽

John L. Krelle ◽

Gere S. diZerega

Keyword(s):

Back Pain ◽

Lower Back Pain ◽

Lumbar Discectomy ◽

Leg Pain ◽

Lower Back

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Application of continuous epidural anesthesia in transforaminal lumbar endoscopic surgery: a prospective randomized controlled trial

Journal of International Medical Research ◽

10.1177/0300060518817218 ◽

2019 ◽

Vol 47 (3) ◽

pp. 1146-1153 ◽

Cited By ~ 1

Author(s):

Tiantong Xu ◽

Rong Tian ◽

Pan Qiao ◽

Zhihua Han ◽

Qingfeng Shen ◽

...

Keyword(s):

Back Pain ◽

Lower Back Pain ◽

Epidural Anesthesia ◽

Leg Pain ◽

X Ray ◽

Lower Back ◽

Group A ◽

Vas Scores ◽

Group B ◽

Surgical Duration

Objective This study aimed to compare intraoperative lower back pain and leg pain, surgical time, and intraoperative X-ray dose in patients offered local infiltration anesthesia or continuous epidural anesthesia for transforaminal endoscopic spine system (TESSYS) surgery. Methods A total of 98 patients who received TESSYS treatment for single-segmental lumbar disc herniation were included, and were randomly divided into two groups: group A (49 cases; local infiltration anesthesia) and group B (49 cases; continuous epidural anesthesia). Surgical duration, intraoperative X-ray dose, and visual analog scale (VAS) scores of lower back pain and leg pain before surgery, during surgery, and 48 h after surgery were recorded and compared. Results After surgery, the VAS scores of both lower back pain and leg pain decreased in group A, and similar findings were found in group B. Group B had a shorter surgical duration, lower intraoperative X-ray dose, and lower intraoperative VAS scores of lower back pain and leg pain compared with group A. Conclusion Compared with local infiltration anesthesia, continuous epidural anesthesia was more effective for pain relief during TESSYS for single-segmental lumbar disc herniation, and also contributed to a shorter surgical duration and lower X-ray exposure.

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