scholarly journals Five Cases of Lumbar Disc Herniations with Apparent Radiculopathy showing Resolution on Follow-up MRI Studies

1998 ◽  
Vol 7 (11) ◽  
pp. 671-677
Author(s):  
Hiroshi Suzui ◽  
Junya Hanakita ◽  
Hideyuki Suwa
Keyword(s):  
Lumbar Disc ◽  
Mri Studies ◽  
Disc Herniations

scholarly journals Difficulty differentiating between a posterior extradural lumbar tumor versus sequestered disc even with gadolinum-enhanced MRI

2021 ◽  
Vol 12 ◽  
pp. 267
Author(s):  
Maurizio Passanisi ◽  
Gianluca Scalia ◽  
Paolo Palmisciano ◽  
Daniele Franceschini ◽  
Antonio Crea ◽  
...  
Keyword(s):  
Disc Herniation ◽  
Lumbar Disc ◽  
Case Description ◽  
Enhanced Mri ◽  
Mri Studies ◽  
Contrast Enhanced ◽  
Disc Herniations ◽  
Contrast Enhanced Mri

Background: Differentiating between posterior extradural tumors versus sequestered lumbar disc herniations may be difficult even utilizing contrast-enhanced MR scans. Case Description: A 49-year-old male acutely presented with an incomplete cauda equine syndrome. When the MRI showed a L4-L5 posterior extradural lesion that enhanced with gadolinium, an urgent left hemilaminectomy was performed. The lesion proved to be a sequestrated disc herniation rather than a tumor. Notably, postoperatively the patient almost completely recovered after 6-month follow-up. Conclusion: Even on contrast-enhanced MRI studies, posterior extradural sequestered lumbar disc herniations may mimic tumors.

Long-term follow-up of standard microdiscectomy versus minimal access surgery for lumbar disc herniations

2013 ◽  
Vol 155 (12) ◽  
pp. 2333-2338 ◽  
Author(s):  
J. Gempt ◽  
M. Jonek ◽  
F. Ringel ◽  
A. Preuß ◽  
P. Wolf ◽  
...  
Keyword(s):  
Lumbar Disc ◽  
Minimal Access Surgery ◽  
Minimal Access ◽  
Long Term Follow Up ◽  
Disc Herniations ◽  
Access Surgery

scholarly journals Surgical management of recurrent disc herniations with microdiscectomy and long-term results on life quality: Detailed analysis of 70 cases

2016 ◽  
Vol 7 (01) ◽  
pp. 87-90 ◽  
Author(s):  
Serdal Albayrak ◽  
Sait Ozturk ◽  
Emre Durdag ◽  
Ömer Ayden
Keyword(s):  
Quality Of Life ◽  
Facet Joint ◽  
Lumbar Disc ◽  
Life Quality ◽  
Early Period ◽  
Long Term Results ◽  
Disc Herniations

ABSTRACT Background: Aim of this paper is to recall the surgical technique used in the recurrent lumbar disc herniations (LDHs) and to share our experiences. Materials and Methods: Out of series of 1115 patients who underwent operations for LDH between 2006 and 2013, 70 patients underwent re-operations, which were included in this study. During surgery, lateral decompression performed over the medial facet joint to the superior facet joint border was seen after widening the laminectomy defect, and microdiscectomy was performed. The demographic findings of the patients, their complaints in admission to hospital, the level of operation, the condition of dural injury, the first admission in the prospective analysis, and their quality of life were evaluated through the Oswestry scoring during their postoperative 1st, 3rd, 6th-month and 1st, 3rd, 5th and 7th-year follow-up. In the statical analysis, Friedman test was performed for the comparison of the Oswestry scores and Siegel Castellan test was used for the paired nonparametrical data. A P < 0.05 was considered statistically significant. Results: Considering the Oswestry Index during the follow-ups, the values in the postoperative early period and follow-ups were seen to be significantly lower than those at the time of admission to hospital (P < 0.05). None of the patients, who re-operated by microdiscectomy, presented with iatrogenic instability in 7 years follow-up period. Conclusion: Microdiscectomy performed through a proper technique in the re-operation of recurrent disc herniations eases complaints and improves the quality of life. Long-term follow-ups are required for more accurate results.

Anterior Lumbar Microdiscectomy and Interbody Fusion for the Treatment of Recurrent Disc Herniation

Neurosurgery ◽  
2001 ◽  
Vol 48 (2) ◽  
pp. 334-338 ◽  
Author(s):  
A. Giancarlo Vishteh ◽  
Curtis A. Dickman
Keyword(s):  
Interbody Fusion ◽  
Lumbar Disc ◽  
Posterior Longitudinal Ligament ◽  
Radicular Pain ◽  
Neurological Deficits ◽  
Herniated Disc ◽  
X Rays ◽  
Lumbar Microdiscectomy ◽  
Disc Herniations

Abstract OBJECTIVE To demonstrate the feasibility of anterior lumbar microdiscectomy in patients with recurrent, sequestered lumbar disc herniations. METHODS Between 1997 and 1999, six patients underwent a muscle-sparing “minilaparotomy” approach and subsequent microscopic anterior lumbar microdiscectomy and fragmentectomy for recurrent lumbar disc extrusions at L5–S1 (n = 4) or L4–L5 (n = 2). A contralateral distraction plug permitted ipsilateral discectomy under microscopic magnification. Effective resection of the extruded disc fragments was accomplished by opening the posterior longitudinal ligament. Interbody fusion was performed by placing cylindrical threaded titanium cages (n = 4) or threaded allograft bone dowels (n = 2). RESULTS There were no complications, and blood loss was minimal. Follow-up magnetic resonance imaging revealed complete resection of all herniated disc material. Plain x-rays revealed excellent interbody cage position. Radicular pain and neurological deficits resolved in all six patients (mean follow-up, 14 mo). CONCLUSION Anterior lumbar microdiscectomy with interbody fusion provides a viable alternative for the treatment of recurrent lumbar disc herniations. Recurrent herniated disc fragments can be removed completely under direct microscopic visualization, and interbody fusion can be performed in the same setting.

scholarly journals Clinical and imaging selection criteria treating lumbar disc herniations by oxygen-ozone therapy, corticosteroid and local anaesthetic.

2021 ◽  
Vol 4 (5) ◽  
pp. 57
Author(s):  
Mario Muto ◽  
Francesco Giurazza ◽  
Ricardo Pimentel Silva ◽  
Gianluigi Guarnieri
Keyword(s):  
Selection Criteria ◽  
Treatment Approach ◽  
Lumbar Disc ◽  
Public Health Problem ◽  
Ozone Therapy ◽  
Invasive Treatment ◽  
Important Public Health Problem ◽  
Effective Option ◽  
Disc Herniations

Radicular lumbar back pain is an important public health problem not already provided with a unequivocal treatment approach. Medical and physical therapies represent the first solution, however when these are not successful, the second therapeutic step is still controversial and mini-invasive treatment may play an important role. In these cases oxygen-ozone therapy has been proved to be a very safe and effective option that is widely used with different modalities. This paper, by reviewing oxygen-ozone therapy literature data, aims to propose an effective procedural technique and to clarify patient’s selection criteria; furthermore complications and follow-up management are also considered.

scholarly journals Revision after failed discectomy

2019 ◽  
Vol 29 (S1) ◽  
pp. 14-21
Author(s):  
Christoph Mehren ◽  
Lorenz Wanke-Jellinek ◽  
Andreas Korge
Keyword(s):  
Lumbar Disc ◽  
Clinical Results ◽  
Scar Tissue ◽  
Common Complication ◽  
Disc Herniations ◽  
Clear Guideline ◽  
Supplementary Material ◽  
Clinical Register ◽  
Recurrent Lumbar Disc Herniation

Abstract Purpose Recurrent lumbar disc herniation is the most common complication after discectomy. Due to the altered anatomy with the presence of scar tissue, the surgical revision of already operated patients could be a surgical challenge. Methods We describe the microsurgical revision technique step by step with the evaluation of our own clinical results in comparison with primary lumbar disc surgeries. The clinical data are based on a clinical register with 2576 recorded primary surgeries (PD) and 592 cases of revisions (RD) with 12- and 24-month follow-up (FU). The intraoperative dura lesion rates of the surgeries between 2016 and 2018 were recorded retrospectively. Data from 894 primary disc surgeries and 117 revisions were evaluated. Results The ODI and the VAS for leg and back pain improved in both groups significantly with slightly inferior outcome of the revision group. The ODI improved from 46.3 (PD) and 45.9 (RD), respectively, to 12.6 (PD) and 22.9 (RD) at the 24-month FU. The VAS dropped down as well in both group [VAS back: 47.8 (PD) and 43.9 (RD) to 19.9 and 32.2 at the 24-month FU; VAS leg: 62.9 (PD) and 65.5 (RD) to 15.6 and 26.8 at the 24-month FU]. During the primary interventions, we observed 1.5% (11/894) and during revisions 7.7% (9/117) of dura lesions. Conclusions There is no clear guideline for the surgical treatment of recurrent disc herniations. In most cases, a pure re-discectomy is sufficient and can be performed safely and effectively with the help of a microscope. Graphic abstract These slides can be retrieved under Electronic Supplementary Material.

scholarly journals Trans-Tubular Translaminar Microscopic-Assisted Nucleotomy for Lumbar Disc Herniations in the Hidden Zone

2021 ◽  
pp. 219256822199042
Author(s):  
Hamdan Abdelrahman ◽  
Sadat Seyed-Emadaldin ◽  
Branko Krajnovic ◽  
Ali Ezzati ◽  
Ahmed Shawky Abdelgawaad
Keyword(s):  
Lumbar Disc ◽  
Minimal Invasive ◽  
Leg Pain ◽  
Invasive Technique ◽  
Improvement Rate ◽  
Neurological Improvement ◽  
Minimally Invasive Surgical ◽  
Disc Herniations ◽  
The Mean

Study Design: A prospective cohort study in a high-flow spine center in Germany. Objectives: This study aimed to evaluate clinical outcomes and complications of the trans-tubular translaminar microscopic-assisted percutaneous nucleotomy in cases of cranially migrated lumbar disc herniations (LDH). Methods: Between January 2013 and January 2018, 66 consecutive patients with cranio-laterally migrated LDH were operated upon. The following outcome measures were evaluated: (1) Visual Analog Scale (VAS) for leg and back pain; (2) Oswestry Disability Index (ODI) and Macnab´s criteria. All patients were operated upon with trans-tubular Translaminar Microscopic-assisted Percutaneous Nucleotomy (TL-MAPN). Perioperative radiographic and clinical evaluations were reported. The mean follow-up period was 32 months. Results: The mean age was 59 years. L4/L5 was the commonest affected level (27 patients). The mean preoperative VAS for leg pain was 6.44 (±2.06), improved to 0,35 (±0.59) postoperatively. Dural injury occurred in 1 patient, treated with dural patch. Improved neurological function was reported in 41/44 Patients (neurological improvement rate of 93%) at the final follow up. There was a significant improvement in the mean ODI values, from 50.19 ± 4.92 preoperatively to 10.14 ± 2.22 postoperatively (P < 0.001). Sixty four out of 66 patients (96%) showed an excellent or good functional outcome according to Macnab´s criteria. No recurrent herniations were observed. Conclusion: The translaminar approach is a viable minimal invasive technique for cranially migrated LDH. The preservation of the flavum ligament is one of the main advantages of this technique. It is an effective, safe and reproducible minimally invasive surgical alternative in treatment of cranially migrated LDHs.

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