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Query: UMLS:C0019270 (hernia)
 15,856 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In order to elaborate an epidurographic technique, the water-soluble contrast substance (verografin), oil solution of iodine, iodolipol and air were used in experimental studies on animals and in cadavers. The studies demonstrated that oil and gaslike contrast substances penetrate into the vein and create a threat of embolia formation. For epidurography the most acceptable are water-soluble contrast substances. The method of an ascending verografin epidurography was elaborated and used in clinical practice. Some indications and contraindications for epidurography are outlined. A group of 396 patients with osteochondrosis of the lumbar part of the spine was examined. The method allowed a topic diagnosis of the disc hernia not only along the spine, but in the cross-section of the motor segments (median, paramedian and lateral hernias). The studies make it possible to exclude a disc prolapse in a nonhernial form of osteochondrosis. In 32 patients with spinal tumors epidurography permitted to determine the initial growth of the tumor, its size and relation to the dura mater.
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PMID:[Verografin epidurography in the diagnosis of spinal and spondylogenic diseases]. 45 88

A biomechanical model of the spine motion segment L2/L3 consisting of the truncated vertebrae, endplates, intervertebral disc and pieces of anterior and posterior longitudinal ligaments has been used for a computer simulation study. A non-linear finite element analysis has shown that small loads compressing the spine, not greater than those occurring in everyday life, cause loss of stability of an intervertebral disc, resulting in lateral dislocation of its nucleus pulposus. This could be a potential cause of discopathy. The model indicates that conservative therapy of herniated disc by the traction method may result in retraction of hernia by about 40 per cent.
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PMID:Non-linear finite element analysis of formation and treatment of intervertebral disc herniae. 130 Jan 14

In a patient with disk herniation it is often difficult to establish that the disk is free in the spinal canal. A retrospective medical record study comparing 65 cases of free herniated disk (FHD) confirmed upon surgery and 65 cases of disk protrusion (DP) demonstrated that FHD was more common in young male blue collar workers, especially those who worked in the sitting position. No clinical findings were diagnostic of FHD although the straight-leg raising test was positive at smaller angles than in disk protrusion. In this study, sensitivity and specificity of CT scan for the diagnosis of FHD were 75% and 80%, respectively. CT scan findings suggestive of FHD included a free disk fragment, found in 22.5% of cases, and an acute connecting angle. Saccoradiculography was more sensitive but less specific than CT scan in this study. In FDH, migration was common and ragged hernia contours were seen on the saccoradiculography images.
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PMID:[Diagnosis of extruded herniated disks]. 148 38

The authors reviewed 200 cases of operated lumbar disk hernias. Hernias of the L4-L5 disk were twice as frequent as those of the L5-S1 disk. When clinical examination revealed simultaneous involvement of the L5 and S1 nerve roots, the L4-L5 disk was more frequently responsible (75%). Clinical examination alone was not sufficient to localize the level of the disk hernia and CT scan used for this purpose had a sensitivity of 93.2%. In 20% of cases, the CT scan demonstrated a second asymptomatic lesion. The results of surgical treatment were assessed as 83% good and very good results and 50% complete cures. The authors propose the following recommendations: Look for involvement of the L5 and S1 nerve roots which is suggestive of an L4-L5 hernia; only operate after radiological demonstration of the level of the herniated disk; do not operate on asymptomatic lesions detected by CT scan.
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PMID:[Critical study of 200 surgically treated lumbar disk hernias]. 217 45

A) Frequency of Far Lateral Lumbar Disc Herniation: The analysis of pre-operative computer-assisted tomograms and myelograms in a series of 694 operated lumbar disc herniations showed that a far lateral disc prolapse occured in 7% of the cases. Within the group of those far laterally herniated discs 3% of the herniations were predominantly located in the intervertebral foramen, whereas 4% of the protruded discs were mainly situated extraforaminally compressing the spinal nerve in its paravertebral course. B) Surgical Management of Extraforaminal Far Lateral Lumbar Disc Herniation: By March 1988 40 patients had been operated on for an extraforaminal disc protrusion making use of an external microsurgical exposure (in two cases by a transmuscular approach and in 38 cases via an enlarged midline approach). A medium-term follow-up of these 40 patients revealed a substantial clinical relief of pain in 34 cases (85%). Based on these gratifying results we regard the external exposure of the extraforaminally protruded disc as the treatment of choice.
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PMID:Frequency and specific surgical management of far lateral lumbar disc herniations. 227 23

Herniation of a thoracic disc in an acromegalic giant is reported. Degenerative changes in the spine in association with dorsal kyphosis, and the additional strain, resulted in the disc prolapse.
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PMID:Thoracic disc herniation in acromegaly. 255

Results are reported of a multicenter analytic-statistical CT study on 128 postoperative lumbar herniated disk (HD) cases (50 at L4-L5, 64 at L5-S1, 2 at L3-L4, 12 multiple). CT was performed from 10 days to 204 months (47.7 months of mean) after surgery, in 51 patients without and in 77 with intravenous contrast medium (42 in bolus, 35 in perfusion). In 59 cases (38%) a recurrent hernia was found, and in 8% a new hernia. In 81% of patients epidural fibrous scars were demonstrated, in a rough 50% of cases associated with recurrent/new hernia: posterior fibrosis was found in 81% of cases, while unilaterally, bilaterally, or anteriorly extended fibroses were present in 20%, in 4.7%, and in 29% of cases respectively. In 72% of the patients injected with contrast medium, various kinds of fibrosis contrast enhancement were detected. In 8% neither fibrosis nor recurrent herniation was found. In 22% of cases lateral and/or central bony canal stenosis was present, in 26% vacuum disk, in 9% intracanalar calcifications, in 39% and in 19.5% dural sac stretching and compression respectively. In 5 cases a pseudomeningocele was found, and in 3 only a postoperative diskitis. Fibrosis is an almost inevitable postoperative consequence (4 out of 5 cases); it can be demonstrated by CT with high sensitivity and good specificity. A series of diagnostic criteria, such as the post-contrast media reaction, allow fibrosis to be discriminated from recurrent hernia. However, the possible association must be kept in mind of both diseases and/or of included roots in the scar. Myelography is hardly ever able to supply further resolutive diagnostic elements, while Myelo-CT is sometimes more useful. The importance of bone changes is questionable, with the exception of evident cases of canal stenosis, also because in most cases the radiologist cannot count on a preoperative CT study. Furthermore, the correlation between CT and clinical findings (possible asymptomatic fibrosis) is often difficult, which gives way to contrasting therapeutic attitudes.
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PMID:[Computerized tomography in surgically treated lumbar disk hernia. Multicenter study]. 329 Oct 2

The authors compared the results of preoperative noncontrast CT-scan with surgical findings in 64 patients with lumbar disc prolapse. In 75% of cases CT gave full and proper diagnosis confirmed by surgery. In 12.5% the level of hernia was well established but its direction was different then found on surgery. In 3.1% of cases CT was false negative and false positive in 9.4%. The authors think, that if CT picture reveals the level of hernia which correlates with clinical symptomatology it is absolutely sufficient for planning surgery. In cases with divergence between CT picture and clinical findings, myelography should be performed for establishing a proper diagnosis.
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PMID:The value of noncontrast computed tomography (CT) in the diagnosis of herniated lumbar disc. 340 67

Previous difficulties in the diagnosis of cervical disk hernia were related to lack of non-invasive imaging techniques, but the gap has now been filled by CT scan imaging. A total of 442 patients with pains in neck, shoulder or arm were referred for a CT scan to exclude a cervical disk hernia. Of the group studied, 2% were found to have a herniated disk, 16% a lateral hernia and 9% combined lateral hernia-narrow cervical canal due to concomitant arthrotic changes. Assessment of correlation between CT scan images and myelographic and surgical findings indicated that CT scan imaging is a very precise, non-invasive method for investigation of cervical disk hernia.
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PMID:[Value of high-resolution computed tomography in evaluating cervical herniated disks]. 377 75

The authors report a new case (to be added to the 10 already published in the literature) of damage to the ureter during surgical treatment of a herniated disc. Instruments seeking the hernia perforate the prevertebral ligament and damage the ureter. The diagnosis should have been made rapidly in the light of a difficult postoperative course, the discovery of a pre and laterovertebral effusion by echography and the presence of haematuria and pyuria. In fact the diagnosis was made late, by urography, in the presence of a mass in the flank. Attempted treatment by insertion of a uretic catheter failed and the situation was finally resolved by a second end-to-end ureterorrhaphy after mobilisation of the kidney. The possibility of damage to the ureter during surgery for a disc hernia and the therapeutic possibilities with preservation of the kidney when the diagnosis is made sufficiently early should be familiar to all: neurosurgeon, orthopaedic surgeon and urologist.
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PMID:[A rare complication of disk surgery: ureteral fistula. Apropos of a case following counter-lateral laminectomy]. 688 65


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