• Title/Summary/Keyword: Herniated discs

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Prevalence, Distribution, and Significance of Incidental Thoracic Ossification of the Ligamentum Flavum in Korean Patients with Back or Leg Pain : MR-Based Cross Sectional Study

  • Moon, Bong Ju;Kuh, Sung Uk;Kim, Sungjun;Kim, Keun Su;Cho, Yong Eun;Chin, Dong Kyu
    • Journal of Korean Neurosurgical Society
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    • v.58 no.2
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    • pp.112-118
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    • 2015
  • Objective : Thoracic ossification of the ligamentum flavum (OLF) is a relatively rare disease. Because of ambiguous clinical symptom, it is difficult for early diagnosis of OLF and subsequent treatment can be delayed or missed. Therefore, the purpose of this study is to comprehensively assess the prevalence and distribution of thoracic OLF by magnetic resonance imaging (MRI) and coexisting spinal disease in Korean patients with back pain or leg pain. Methods : The sample included 2134 Korean patients who underwent MRI evaluation for back pain. The prevalence and distribution of thoracic OLF were assessed using lumbar MRI with whole spine sagittal images. Additionally, we examined the presence of coexisting lumbar and cervical diseases. The presence of thoracic OLF as well as clinical parameters such as age, sex, and surgery were retrospectively reviewed. Results : The prevalence of thoracic OLF in total patients was 16.9% (360/2134). The prevalence tended to increase with aging and was higher in women than in men. The lower thoracic segment of T10-11 was the most frequently affected segment. Of the 360 patients with OLF, 31.9% had coexisting herniated thoracic discs at the same level. Approximately 74% of the patients with OLF had coexisting lumbar and cervical disease. Nine (2.5%) of 360 OLF patients underwent surgery for thoracic lesion. Conclusion : The prevalenceof thoracic OLF was relatively higher than those of previous reports. And coexisting lumbar and cervical disease were very frequent. Therefore, we should check coexisting spinal diseases and the exact diagnostic localization of ossification besides lumbar disease.

Hemilaminectomy for Herniated Discs at the Cervicothoracic Junction in a Beagle Dog (편측추궁절제술을 이용한 비글견의 경흉연접부 추간판 탈출증의 치료)

  • Kang, Byung-Jae;Kweon, Oh-Kyeong
    • Journal of Veterinary Clinics
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    • v.31 no.6
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    • pp.511-514
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    • 2014
  • A 7-year-old, female Beagle dog presented with a primary complaint of severe neck pain and paretic gait. A lesion was suspected between C6 and T2 on the basis of neurological examinations. Magnetic resonance imaging of the cervicothoracic spine revealed herniation of disc material from the C7-T1 intervertebral space resulting in marked spinal cord compression. Hemilaminectomy was performed to treat the intervertebral disc disease at C7-T1. Treatment was effective and the clinical condition of the dog was remarkably improved. This result suggests that hemilaminectomy is an effective option for surgical treatment of intervertebral disc disease at the cervicothoracic junction in dogs.

Role of Expression of Inflammatory Mediators in Primary and Recurrent Lumbar Disc Herniation

  • Dagistan, Yasar;Cukur, Selma;Dagistan, Emine;Gezici, Ali Riza
    • Journal of Korean Neurosurgical Society
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    • v.60 no.1
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    • pp.40-46
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    • 2017
  • Objective: To assess role of some inflammatory mediators in patients with primary and recurrent lumbar disc herniation. Expression of IL-6, transforming growth factor (TGF)-1, insulin-like growth factor (IGF)-1, and Bcl-2-associated X protein (BAX) have been shown to be more intense in the primary group than the recurrent goup, but this mediators may be important aspects prognostic. Methods: 19 patients underwent primary and revision operations between June 1, 2009 and June 1, 2014, and they were included in this study. The 19 patients' intervertebral disc specimens obtained from the primary procedures and reoperations were evaluated. Expression of IL-6, TGF-1, IGF-1, and BAX were examined immunohistochemically in the 38 biopsy tissues obtained from the primary and recurrent herniated intervertebral discs during the operation. Results: For IL-6 expression in the intervertebral disc specimens, there was no difference between the groups. The immunohistochemical study showed that the intervertebral disc specimens in the primary group were stained intensely by TGF-1 compared with the recurrent group. Expression of IGF-1 in the primary group was found moderate. In contrast, in the recurrent group of patients was mild expression of IGF-1. The primary group intervertebral disc specimens were stained moderately by BAX compared with the recurrent group. Conclusion: The results of our prognostic evaluation of patients in the recurrent group who were operated due to disc herniation suggest that mediators may be important parameters.

Effects of Low Grade Axial Loading on Discogenic Low Back Pain: A Case Report

  • Chang, Duncan;Boby, Arantxa;Madonna, James
    • Journal of International Academy of Physical Therapy Research
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    • v.9 no.4
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    • pp.1683-1686
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    • 2018
  • Low back pain (LBP) is the most common reason for seeking physical therapy (PT) care. Recent studies suggest that axial loading can have a positive impact on the intervertebral disc by improving its tensile strength. Further, whole body vibration (WBV) appears to improve spinal muscle relaxation. Therefore, this case study describes the use of axial loading using a mini-trampoline in a female with chronic LBP. This case report is a single subject design. This patient is a 29-year-old female with a six-month history of low back pain following a motor vehicle accident. MRI found herniated discs at L4 and L5, clinical tests were positive for pain in the L4 and L5 dermatome and myotome the slump test was positive for neural tension, and LBP was constant at 4-6/10 over the past four months. She received axial loading exercises using a mini-trampoline and performed six sessions that were, scheduled twice a week for three weeks. Her Oswestry Disability Index (ODI) score improved from 40% at the time of her first visit to 22% at her final visit. Pain measure on the Numeric Pain Rating Scale (NPRS) after the first treatment was 7/10, and her pain after the final treatment was 0/10. These changes in the pain scores are clinically significant and exceed the minimal clinically important difference (MCID). This patient had a significant improvement in her pain using the NPRS and the ODI. This case study suggests that axial loading may be an effective treatment for some individuals with discogenic chronic low back pain.

Lumbar Facet Joint Injection: A Review of Efficacy and Safety (요추 후관절 주사: 임상적 유용성과 안전성에 대한 고찰)

  • Yoonah Do;Eugene Lee;Choong Guen Chee;Joon Woo Lee
    • Journal of the Korean Society of Radiology
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    • v.85 no.1
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    • pp.54-76
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    • 2024
  • Facet joint arthrosis is a progressive degenerative disease that is frequently associated with other spinal degenerative disorders such as degenerative disc disease or spinal stenosis. Lumbar facet joint arthrosis can induce pain in the proximal lower extremities. However, symptoms and imaging findings of "facet joint syndrome" are not specific as they mimic the pain from herniated discs or nerve root compression. Currently, evidence for therapeutic intra-articular lumbar facet joint injections is still considered low, with a weak recommendation strength. Nevertheless, some studies have reported therapeutic effectiveness of facet joint injections. Moreover, the use of therapeutic facet joint injections in clinical practice has increased. This review article includes opinions based on the authors' experience with facet joint injections. This review primarily aimed to investigate the efficacy of lumbar facet joint injections and consider their associated safety aspects.