herniated lumbar disc
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Author(s):  
Hoon Seok ◽  
Seung Yeol Lee ◽  
Dong Seong Shin ◽  
Jung Hoon Kang ◽  
Soo Bin Im ◽  
...  

BACKGROUND: Due to the anatomical characteristics of the anterior epidural space, dorsal migration of material from herniated lumbar disc is quite rare. Also, bilateral foot drop due to unilateral dorsal migration of disc herniation is extremely rare. This report presents a case of sudden bilateral foot drop caused by the unilateral dorsal migration of material from a herniated lumbar disc. CASE DESCRIPTION: A 51-year-old male presented with sudden onset severe leg pain with bilateral foot drop. The patient was referred to our emergency department by a local clinic. Neurological examination showed bilateral ankle and big toe dorsiflexion weakness grade 1. There was no perianal anesthesia, anal sphincter weaknesses, or voiding difficulty. Apart from essential hypertension, this patient’s medical history was unremarkable. Magnetic resonance imaging showed that intervertebral disc material in the dorsal extradural space at the L3-4 level had compressed the dural sac from the left side to the center. We performed an emergency operation. The pathologic result revealed fibrous cartilaginous materials. After the operation, the leg pain was markedly resolved. At postoperative three months, the patient showed improvement of foot drop. CONCLUSION: We recommended emergent mass removal, which produced a favorable outcome.


2021 ◽  
Vol 18 (3) ◽  
pp. 10-19
Author(s):  
Hitendra S Naik ◽  
Samarendra Nath Ghosh ◽  
Pradeep Saha ◽  
Parthasarathy Biswas

Introduction: The aim of this 6-month prospective study was to seek out the factors affecting surgical outcome, predictors of treatment response and their correlates in open discectomy for herniated lumbar disc. Methods and Materials: Eighty patients who fulfilled the required criteria were chosen. Socio-demographic, clinical data proforma, Visual Analogue Scale for pain (VAS), Japanese Orthopedic Association (JOA) Scale for subjective and objective pain related QoL, General Health Questionnaire-12 (GHQ-12) for screening mental health, Short Form-36 (SF-36) Health Survey for assessing Health-related Quality of Life (HRQOL) and Montgomery Asberg Depression Rating Scale (MADRS) for measurement of clinical depression were used at the preoperative stage and reassessed again at 1 month, 3 months and 6 months post-discectomy. Results: Postoperatively, VAS and JOA Scale scores continued to show improvement at each follow up (p<0.001). Majority of the SF-36 subscales showed significant improvement at 3-months and 6-months of the postoperative period. A significant correlation was seen between the duration of pain symptoms and depression scores at 6 months (rho 0.301 p<0.01). Baseline VAS score had a significant negative correlation with baseline Physical Functioning and General Health scores at 6 months. The duration and severity of pain symptoms before surgery predicted the depression scores at 6 months (adjusted R square 0.056 p<0.001) postoperatively. Conclusion: The discectomy procedure resulted in significant improvement in baseline subjective pain symptoms and overall HRQOL. Greater the duration and intensity of pain symptoms at baseline, greater was the depression scores and lesser was the SF-36 physical functioning and general health at 6-month postoperative period.


2021 ◽  
Vol 31 (3) ◽  
pp. 125-131
Author(s):  
Ji-Eun Koo ◽  
Hee-Won Lee ◽  
Yong-Su Kwon ◽  
Jae-Eun Yu ◽  
Jun-Hyo Bae ◽  
...  

2021 ◽  
Vol 0 (0) ◽  
pp. 0-0
Author(s):  
Hesham El sayed El sheikh ◽  
Inas Sweed ◽  
Ahmed Deabes ◽  
nour zaghlol

Electronics ◽  
2021 ◽  
Vol 10 (8) ◽  
pp. 982
Author(s):  
Wafa Mbarki ◽  
Moez Bouchouicha ◽  
Frederick Tshibasu Tshienda ◽  
Eric Moreau ◽  
Mounir Sayadi

A frequent cause of lower back pain presenting with leg pain is a herniated lumbar intervertebral disc. A herniation or a herniated lumbar disc is a change of position of disc material (nucleus pulpous or annulus fibrosis). Usually, the lower back pain goes away within days or weeks. Regular treatment techniques for lower back pain include medication, exercises, relaxation methods and surgery. Back pain and back problems regularly occur in the lumbar region. The spinal canal is made up of vertebrae; each one protects the spinal nerves. Intervertebral discs and facet joints connect the vertebrae above and below. Groups of muscles and ligaments hold the vertebrae and the discs together. Muscles support the spine and the body weight, and they allow us to move. Pressure can result in excessive wear and tear of the other structures. For example, a common problem in the lower back is disc herniation. In this case, pressure on an intervertebral disc makes its center, the nucleus pulposus, protrude backwards and push against the spinal nerves, leading to lower back pain. Detection and classification are the two most important tasks in computer aided diagnosing systems. Detection of a herniated lumbar disc from magnetic resonance imaging (MRI) is a very difficult task for radiologist. The extraction of herniated discs has been achieved by different approaches such as active contours, region growing, watershed techniques, thresholding and deep learning. In this study, to detect intervertebral disc from axial MRIs we develop a method using generative adversarial networks (GANs), especially the CycleGAN model, to automatically generate and detect intervertebral disc and to classify the type of the herniated lumbar disc such as foraminal or median. We propose to explore the importance of axial view MRI to determine the herniation type. Accurately, GANs and other generative networks have created several ways to tackle different problems well known and challenging of medical image analysis, such as segmentation, reconstruction, data simulation, medical image de-noising, and classification. Moreover, their efficiency to synthesize images and data at unprecedented levels of realism also gives hope that the chronic scarcity of labeled data in the medical field can be resolved with the help of these generative models. In our case, having a database that contains several images is a very difficult task. In this paper, we put forward a new approach based on GANs, in order to solve the problem of lumbar intervertebral disc images reduction. This method is based especially on CycleGAN. Consequently, the essential objective of our work is to generate and automatically classify the herniation type as foraminal or median using GANs. Our computer aided diagnosis (CAD) system achieved a 97.2% accuracy on our dataset. This result represents a very high-performance results by providing the state of the art and our work utilizing the GANs technique. Our CAD is very effective and efficient for classifying herniations of lumbar intervertebral discs. Therefore, the contribution of this study appears in: firstly, the use of the CycleGAN model based on convolutional layers to detect and classify the herniation type (median or foraminal) in lumbar intervertebral discs, secondly, the use of axial view MRI in order to classify the type of the herniated intervertebral disc. The main objective of this paper is to help radiologists automatically recognize and classify herniated lumbar discs.


2021 ◽  
pp. 52-54
Author(s):  
Ravi Ranjan Singh ◽  
Bharat Singh

INTRODUCTION: Low-back pain is a common clinical presentation of herniated lumbar disc. The incidence of low back pain is high in our country due to difcult working and living environment. The initial treatment of low back pain is conservative. Epidural steroid injection (ESI) is being slowly established as a simple, effective and minimally invasive treatment modality. The aim of this study is to assess the effectiveness of epidural steroid injection for low back and radicular pain. MATERIALS AND METHODS :This is a Prospective observational study. It was carried out on the patients presenting with low back pain due to herniated lumbar disc not responding to conservational management and had Magnetic Resonance Imaging (MRI) proven lumbar disc prolapsed at different level. Injection Methyl prednisolone 80 mg and 2 ml of 0.5% bupivacaine was diluted in 8 ml of normal saline and injected into the affected lumbar epidural space. The functional status of the patient and the severity of pain were evaluated before injection and after injection during the follow-up period by using Ostrewy disability index and visual analogue score. RESULTS: Fifty six patients received the epidural steroid injections, among them three patients did not came for regular follow up till six months and six patients required surgery . remaining forty seven were analyzed , among them 27(55.44%) were male and 20(42.55%) were female. The functional status and pain response of the patients were improved signicantly during all the follow-up periods (p < 0.001). The success rate of this study was 83.92%. No major complications were encountered. CONCLUSION:The ESI is a simple, safe, effective and minimally invasive modality for the management of lumbar radicular pain.


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