scholarly journals Drop-Foot associated with Lumbar Disc Lesion and Stenosis of Lumbar Vertebral Canal A Revied of 12 Operated Cases

1984 ◽  
Vol 32 (4) ◽  
pp. 1014-1020
Author(s):  
K. Arimura ◽  
K. Takara ◽  
H. Fukuyama ◽  
M. Matsuoka ◽  
K. Maekawa ◽  
...  
Keyword(s):  
Lumbar Disc ◽  
Drop Foot ◽  
Vertebral Canal

Management of sciatica due to lumbar disc herniation in the Netherlands: a survey among spine surgeons

2008 ◽  
Vol 9 (1) ◽  
pp. 32-39 ◽  
Author(s):  
Mark P. Arts ◽  
Wilco C. Peul ◽  
Bart W. Koes ◽  
Ralph T. W. M. Thomeer ◽  
_ _
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
The Netherlands ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Low Back ◽  
Drop Foot ◽  
Acute Surgery ◽  
Laser Disc

Object Although clinical guidelines for sciatica have been developed, various aspects of lumbar disc herniation remain unclear, and daily clinical practice may vary. The authors conducted a descriptive survey among spine surgeons in the Netherlands to obtain an overview of routine management of lumbar disc herniation. Methods One hundred thirty-one spine surgeons were sent a questionnaire regarding various aspects of different surgical procedures. Eighty-six (70%) of the 122 who performed lumbar disc surgery provided usable questionnaires. Results Unilateral transflaval discectomy was the most frequently performed procedure and was expected to be the most effective, whereas percutaneous laser disc decompression was expected to be the least effective. Bilateral discectomy was expected to be associated with the most postoperative low-back pain. Recurrent disc herniation was expected to be lowest after bilateral discectomy and highest after percutaneous laser disc decompression. Complications were expected to be highest after bilateral discectomy and lowest after unilateral transflaval discectomy. Nearly half of the surgeons preferentially treated patients with 8–12 weeks of disabling leg pain. Some consensus was shown on acute surgery in patients with short-lasting drop foot and those with a cauda equina syndrome, and nonsurgical treatment in patients with long-lasting, painless drop foot. Most respondents allowed postoperative mobilization within 24 hours but advised their patients not to resume work until 8–12 weeks postoperatively. Conclusions Unilateral transflaval discectomy was the most frequently performed procedure. Minimally invasive techniques were expected to be less effective, with higher recurrence rates but less postoperative low-back pain. Variety was shown between surgeons in the management of patients with neurological deficit. Most responding surgeons allowed early mobilization but appeared to give conservative advice in resumption of work.

scholarly journals Percutaneous Discectomy Followed by CESI Might Improve Neurological Disorder of Drop Foot Patients Due to Chronic LDH

2020 ◽  
Vol 10 (8) ◽  
pp. 539
Author(s):  
Trianggoro Budisulistyo ◽  
Firmansyah Atmaja
Keyword(s):  
Lumbar Disc ◽  
Cauda Equina ◽  
Bowel Dysfunction ◽  
Drop Foot ◽  
Invasive Treatment ◽  
Percutaneous Discectomy ◽  
Transforaminal Approach ◽  
Pain Syndromes ◽  
Epidural Steroid

(1) Introduction: Epiconus and conus medullary syndromes that consisted of drop foot, pain, numbness, bladder or bowel dysfunction are serious problems might be caused by lumbar disc(s) herniation (LDH) compression. (2) Objective: To evaluate percutaneous discectomy effectivity for decompressing LDH lesions. (3) Case Report: Three patients suffered from drop feet, numbness, and bowel and bladder problems due to LDH compression. Patient #1 is a male (35 years old, basal metabolism index (BMI) = 23.9), point 1 on manual muscle test (MMT), with protrusion on L3 to S1 discs; Patient #2 is a female (62 years old, BMI = 22.4), point 3 on MMT, with protrusion on L2-4 and L5-S1 discs; Patient #3 is a female (43 years old, BMI = 26.6), point 4 on MMT, with extrusion on T12-L1 and L1-2 and L3-4 protruded discs. Six months follow-up showed of stand and walkability improvement with Patient #1 and #2. Patient #3 showed improvement in bowel and bladder problems within 10 weeks, without suffering of postoperative pain syndromes. (4) Discussion: Patient #1 and #2 showed better outcomes than Patient #3 who affected epiconus and cauda equina syndromes. Triamcinolone and lidocaine have analgesic and anti-inflammatory properties for improving intraepidural circulation adjacent to the lesion sites. (5) Conclusion: Drop foot caused by mechanical compression of LDH ought to be treated immediately. Lateral or posterolateral compression has better outcomes associated with anatomical structures. Discectomy through transforaminal approach that is followed by caudal epidural steroid injection (CESI) under fluoroscopic guidance is a safer and minimally invasive treatment with promising outcomes.

Lumbar Disc Hernia Secondary to Gunshot Injury

Neurosurgery ◽  
1984 ◽  
Vol 15 (1) ◽  
pp. 73-75 ◽  
Author(s):  
A. Mariottini ◽  
R. Delfini ◽  
P. Ciappetta ◽  
G. Paolella
Keyword(s):  
Gunshot Wound ◽  
Lumbar Disc ◽  
Gunshot Injury ◽  
Vertebral Canal ◽  
Disc Hernia ◽  
Disc Material ◽  
Lumbar Disc Hernia

Abstract The authors present a case of injury to the 4th lumbar root secondary to a gunshot wound. The lesion was not directly related to the traumatic action of the projectile, but was caused by the compressive action of disc material forced into the vertebral canal as a result of the destructive effects of a 7.65 caliber bullet.

scholarly journals Drop Foot Associated with Lumbar Disc Herniation and Lumbar Canal Stenosis

2011 ◽  
Vol 60 (2) ◽  
pp. 269-272
Author(s):  
Eiichiro Okuma ◽  
Tsugukazu Toma ◽  
Kotatsu Urasaki ◽  
Tadakatsu Kinjo ◽  
Satoshi Kinjo ◽  
...  
Keyword(s):  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Drop Foot ◽  
Lumbar Canal Stenosis ◽  
Canal Stenosis

A radiological study on lumbar disc syndrome

1976 ◽  
Vol 12 (2) ◽  
pp. 320
Author(s):  
HW Lee ◽  
BC Min ◽  
JS Yoon ◽  
JH Ko
Keyword(s):  
Lumbar Disc ◽  
Radiological Study

PEID (Percutaneous Endoscopic Interlaminar Discectomy): Cautionary Points Based on the Evidence

2018 ◽  
Vol 1 (2) ◽  
pp. 7
Author(s):  
Jun Ho Lee
Keyword(s):  
Lumbar Disc ◽  
Lumbar Discectomy ◽  
Radiographic Evaluation ◽  
Operative Indication ◽  
Endoscopic Techniques ◽  
Bone Removal ◽  
Iatrogenic Trauma ◽  
Minimal Damage ◽  
Surgical Modality ◽  
Endoscopic Lumbar Discectomy

Background: Percutaneous endoscopic lumbar discectomy (PELD) is one of the most sophisticated operative procedures for the treatment of lumbar disc herniation (LDH). Endoscopic techniques are now becoming standard in many areas due to expanded technical possibilities of full-endoscopic transforaminal or interlaminar resection of herniated lumbar discs as well as stenosis. However conventional percutaneous endoscopic interlaminar discectomy (PEID) disc operations may sometimes result in subsequent untoward complications due to unnoticed iatrogenic trauma to neural structures, which is mostly related to an anatomical limitation during endoscope insertion.Methods: An appropriate operative indication of the PEID without bone removal or laminectomy can be used to treat LDH cases with an enough interlaminar space (at least ≥ 20 mm by bi-facetal distance) from the reported evidences. Otherwise, there might be several indications for requirement of bone removal; a narrow interlaminar space, disappearance of the concave shape of the upper vertebral laminae, high-grade migration of LDH, recurrent LDH, obesity, or an immobile nerve root.Conclusion: The significance of PEID lies also in its minimal damage to surrounding structures such as muscle, bone, and ligaments. A discrete radiographic evaluation from the patient preoperatively is mandatory before choosing a proper endoscopic surgical modality for the sake of optimal clinical outcome after PEID. 

Recurrence Rate of Lumbar Disc Herniation After Standard Discectomy and Microdiscectomy: A 5-Year Study

2019 ◽  
Vol 12 (2) ◽  
pp. 139-146
Author(s):  
Mladen E. Ovcharov ◽  
Iliya V. Valkov ◽  
Milan N. Mladenovski ◽  
Nikolay V. Vasilev
Keyword(s):  
Recurrence Rate ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Surgical Techniques ◽  
Reoperation Rate ◽  
University Hospital ◽  
Recurrence Rates ◽  
Chi Square ◽  
Common Procedure

Summary Lumbar disc herniation (LDH) is the most common pathology in young people, as well as people of active age. Despite sophisticated and new minimally invasive surgical techniques and approaches, reoperations for recurrent lumbar disc herniation (rLDH) could not be avoided. LDH recurrence rates, reported in different studies, range from 5 to 25%. The purpose of this study was to estimate the recurrence rates of LDH after standard discectomy (SD) and microdiscectomy (MD), and compare them to those reported in the literature. Retrospectively, operative reports for the period 2012-2017 were reviewed on LDH surgeries performed at the Neurosurgery Clinic of Dr Georgi Stranski University Hospital in Pleven. Five hundred eighty-nine single-level lumbar discectomies were performed by one neurosurgeon. The diagnoses of recurrent disc herniation were based on the development of new symptoms and magnetic resonance/computed tomography (MRI/CT) images showing compatible lesions in the same lumbar level as the primary lumbar discectomies. The recurrence rate was determined by using chi-square tests and directional measures. SD was the most common procedure (498 patients) followed by MD (91 patients). The cumulative reoperation rate for rLDH was 7.5%. From a total number of reoperations, 26 were males (59.1%) and 18 were females (40.9%). Reoperation rates were 7.6% and 6.6% after SD and MD respectively. The recurrence rate was not significantly higher for SD. Our recurrence rate was 7.5%, which makes it comparable with the rates of 5-25% reported in the literature.

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