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

This article reports the outcomes of 1072 consecutive patients surgically treated during a ten-year period. There are many new techniques for the treatment for lumbar disc hernia, but also the conventional standard discectomy procedure is still the most acceptable method today. 1072 consecutive, non-randomized patients with lumbar disc herniation were reviewed for a clinical retrospective study about the surgical outcome according to our functional grading system. The patients reported ruptured disc to be due to lifting (30.13%), trauma (9.42%), and sports (8.11%). Almost all patients had complained of radicular pain in a dermatomal distribution (90.39%) and 86.07% had low-back pain, 5.2% of the patients had complications. Eighty-five patients (7.92%) had a second lumbar disc operation. Thirty of these eighty-five patients underwent the operation at the same level. Patients were also rated to improve the ability. Almost 91% of the patients had excellent, good, and satisfactory outcome; 9% of patients had moderate and poor categories of outcome. Several conclusions can be drawn from this large series of patients who were operated for lumbar disc herniation. 1. Most patients had good-to-excellent surgical outcomes after lumbar discectomy. 2. The results of disc surgery depend not only upon operative technique and skill, the degree of neurological impairment but also upon the correct selection of cases.
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PMID:Outcome analyses in 1072 surgically treated lumbar disc herniations. 1042 99

A 44-year-old woman who weighed 130 kg (height 158 cm, BMI 52) with a complicated psychiatric history was referred for obesity surgery because of severe sleep apnea, obesity hypoventilation syndrome with frequent pneumonias, arterial hypertension, diabetes mellitus, polyarthralgia and back pain, venous insufficiency, dysmenorrhea, severe heartburn, and incisional hernia. From childhood until 1983, she had undergone 106 operations, mainly for septic/pyemic and intra-abdominal abscesses, 86 of them under general anesthesia. In the 4 years before undergoing bariatric surgery, she had gained 40 kg, nonoperative attempts at weight reduction had failed. Some months before obesity surgery she could fall asleep while standing, and she noticed an entire loss of capacity for work. Respiratory disturbance index measured during sleep by Mesam-4 device was 68 events per hour. Preoperative controlled positive airway pressure (C-PAP) therapy was used. Vital indications for weight reduction were established. Bariatric surgical steps included six operations: (1) vertical banded gastroplasty (VBG); (2) relaparotomy with suspicion of peritonitis, no complications found; (3) hernioplasty simultaneously with panniculectomy; (4) revision and removal of additional flap because of marginal skin necrosis; (5) bilateral thigh dermatolipectomy simultaneously with right-side saphenectomy; and (6) removal of intramammary abscess. Twenty-four months after VBG, she had lost 39 kg (56.5 % EWL) and was doing rather well. Obesity-related diseases except back pain were relieved.
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PMID:Successful bariatric surgery in a patient who underwent more than 100 various operations. 1048 18

A 16-year-old male experienced a sudden attack of back pain while walking through the corridor of school which required emergent hospitalization. Except for the back pain, no neurological symptoms were noted. Magnetic resonance (MR) imaging indicated an angiopathy-like flow void in the epidural region at Th 3-5 which seemed to explain the patient's back pain. Thoracic laminectomy at Th 3-5 and resection of the affected site were performed. Pathologically, the resected lesion only had a dilated normal vein and no findings indicating vascular deformity. The patient's outcome was good and no relapse of pain has occurred for about 2 years since the operation. Although some authors have reported vascular deformity with spinal epidural hemorrhage or varices with lumbar hernia of the intervertebral disc, there is no report concerning spinal epidural varices with pain only. The present case seemed to be a rare event and is reported here.
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PMID:Spinal epidural varices. 1053 79

A 71-year-old female with esophagohiatal hernia underwent a laparoscopic Nissen's fundoplication under general anesthesia. During the operation a Savary-Gilliard bougie was temporarily inserted to the esophagus to prevent esophagostenosis. After the emergence from anesthesia, the patient complained of severe back pain and developed tachypnea and a low SpO2 associated with an enlargement of mediastinal shadow on the chest X-ray, suggesting mediastinal perforation. Examination by endoscopy and thoracotomy revealed a pyriform sinus perforation reaching down to the mediastinum. This case demonstrates the possibility of accidental perforation by various devices inserted blindly to esophagus, especially during general anesthesia, and the importance of close observation of patients after the emergence from anesthesia.
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PMID:[Accidental pyriform sinus perforation with Savary-Gilliard esophageal bougie during general anesthesia]. 1088 43

Using a special software program we measured spinopelvic parameters on digitised radiographs of the entire spine and the pelvis of 50 patients with lumbar disc herniation and compared these with the same measurements on 30 healthy subjects. In the disc hernia group the patients had a relatively straight spine in the sagittal plane. The sacrum was more vertical, and the value of the lumbar lordosis was lower, as was the amplitude of the spinal curvatures, when compared with those of the healthy group. This results in a higher gravitational compressive force which may, in turn, lead to progressive degeneration of the discs. The anterior shift of the line of gravity may cause spinopelvic instability, and contraction of the posterior spinal muscles in trying to balance this disturbed spatial relationship may produce back pain.
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PMID:The importance of spinopelvic parameters in patients with lumbar disc lesions. 1207 71

A case is described of a 47-year-old man with achondroplasia who presented with lower back pain radiating to his left loin. An intravenous urogram (IVU) showed hydronephrosis on the left side and a dilated left ureter passing down into the left inguinal region. A CT scan confirmed a left inguinal hernia containing the left ureter causing ureteric obstruction. The hernia was repaired using the Lichtenstein technique with the ureter replaced retroperitoneally. A postoperative IVU showed recovery in renal function but with a persistently dilated left ureter that was not obstructed. A review of the literature regarding inguinal herniation involving the ureter is presented.
Hernia 2003 Jun
PMID:An unusual cause of back pain in an achondroplastic man. 1282 33

Although back disorders are a major occupational problem for nursing staff, few studies distinguish different types. By means of a structured questionnaire, we performed a cross-sectional study on the prevalence of diagnosed lumbar disc hernia, chronic low-back pain (LBP) (at least 90 d in the preceding 12 months) and acute LBP (intense pain for at least 1 d) with respect to physical, individual and psychosocial factors among female nurses (n=587), nursing aides (n=228) and head-nurses (n=43) working in a university hospital (95% of the female workforce). Almost all respondents reported known high-risk occupational activities. Overall prevalence of reported back disorders was 44% (acute LBP 19%, chronic LBP 17%, lumbar hernia 8%). On multinomial logistic regression analysis, scoliosis and commonly stress-related psychosomatic symptoms were associated with all three types of back disorder; trauma/fractures of the spine, pelvis and/or legs and a global work-environment/job-satisfaction score with acute LBP; increasing age with lumbar disc hernia. While confirming the relevance of considering different definitions of back disorder, our data indicate items for investigation in cohort studies. These include: identification of specific risk factors for lumbar hernia; avoidance of possible work-environment risk factors such as hurried execution of different tasks at the same time; and influence on job suitability of underlying spinal pathologies such as scoliosis.
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PMID:Associations of psychosocial and individual factors with three different categories of back disorder among nursing staff. 1509 Jun 84

The primary joint hypermobility syndrome (pJH) is an overlap disorder of connective-tissue dysplasias, which incorporates features seen in the Marfan syndromes (MFS), Ehlers-Danlos syndromes (EDS), and osteogenesis imperfecta. Patients with pJH usually present arthralgia, back pain, soft-tissue lesions, recurrent joint dislocation, or subluxation. Extraarticular features may include, e. g., striae cutis, keratoconus, easy bruising, mitral valve prolapse, aortic incompetence, aneurysms, pneumothorax, hernia, urinary incontinence, and pelvic floor prolapse. Due to the high frequency of critical dissection and rupture, the early recognition of rare life-threatening complications such as dilatation of the aortic root and aneurysms is important. Therefore, patients (and their family members) with pJH should also be examined for life-threatening features seen in MFS and EDS.
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PMID:[Concomitant diseases in primary joint hypermobility syndrome]. 1549 74

The authors report their experience with 42 patients in whom anterior lumbar fusion was performed using titanium cages as a versatile adjunct to treat a wide variety of spinal deformity and pathological conditions. These conditions included congenital, degenerative, iatrogenic, infectious, traumatic, and malignant disorders of the thoracolumbar spine. Fusion rates and complications are compared with data previously reported in the literature. Between July 1996 and July 1999 the senior authors (C.I.S., R.P.N., and M.J.R.) treated 42 patients by means of a transabdominal extraperitoneal (13 cases) or an anterolateral extraperitoneal approach (29 cases), 51 vertebral levels were fused using titanium cages packed with autologous bone. All vertebrectomies (27 cases) were reconstructed using a Miami Moss titanium mesh cage and Kaneda instrumentation. Interbody fusion (15 cases) was performed with either the BAK titanium threaded interbody cage (in 13 patients) or a Miami Moss titanium mesh cage (in two patients). The average follow-up period was 14.3 months. Seventeen patients had sustained a thoracolumbar burst fracture, 12 patients presented with degenerative spinal disorders, six with metastatic tumor, four with spinal deformity (one congenital and three iatrogenic), and three patients presented with spinal infections. In five patients anterior lumbar interbody fusion (ALIF) was supplemented with posterior segmental fixation at the time of the initial procedure. Of the 51 vertebral levels treated, solid arthrodesis was achieved in 49, a 96% fusion rate. One case of pseudarthrosis occurred in the group treated with BAK cages; the diagnosis was made based on the patient's continued mechanical back pain after undergoing L4-5 ALIF. The patient was treated with supplemental posterior fixation, and successful fusion occurred uneventfully with resolution of her back pain. In the group in which vertebrectomy was performed there was one case of fusion failure in a patient with metastatic breast cancer who had undergone an L-3 corpectomy with placement of a mesh cage. Although her back pain was immediately resolved, she died of systemic disease 3 months after surgery and before fusion could occur. Complications related to the anterior approach included two vascular injuries (two left common iliac vein lacerations); one injury to the sympathetic plexus; one case of superficial phlebitis; two cases of prolonged ileus (greater than 48 hours postoperatively); one anterior femoral cutaneous nerve palsy; and one superficial wound infection. No deaths were directly related to the surgical procedure. There were no cases of dural laceration and no nerve root injury. There were no cases of deep venous thrombosis, pulmonary embolus, retrograde ejaculation, abdominal hernia, bowel or ureteral injury, or deep wound infection. Fusion-related complications included an iliac crest hematoma and prolonged donor-site pain in one patient. There were no complications related to placement or migration of the cages, but there was one case of screw fracture of the Kaneda device that did not require revision. The authors conclude that anterior lumbar fusion performed using titanium interbody or mesh cages, packed with autologous bone, is an effective, safe method to achieve fusion in a wide variety of pathological conditions of the thoracolumbar spine. The fusion rate of 96% compares favorably with results reported in the literature. The complication rate mirrors the low morbidity rate associated with the anterior approach. A detailed study of clinical outcomes is in progress. Patient selection and strategies for avoiding complication are discussed.
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PMID:Anterior lumbar fusion with titanium threaded and mesh interbody cages. 1691 6

The studied population (1000 children and young workers and 250 controls) were interviewed for health complaints and subjected to extensive medical investigations. Health problems are more encountered among the workers than in the controls, which has been attributed to the impact of work on health and to the low socioeconomic background that compels the children to work, which may constitute a potential health problem from the start. The significant health problems include: a) Respiratory system complaints, attacks of cough, chronic bronchitis, bronchial asthma and reduction in FEV1.0/FVC; b) cardiovascular abnormalities including palpitations, sinus tachycardia, anemia, vertigo and syncope; c) gastrointestinal abnormalities including dyspepsia and parasitic infestations; d) neuropsychiatric complaints; and e) other health problems including urinary tract infections, backache, visual impairment, repair of hernia and nocturnal enuresis. The study has been concluded by recommending the use of primary health care approach to child labour, emphasizing the importance of pre-employment and periodical medical examinations for protecting this vulnerable group from work hazards, and expanding the efforts of family planning to reduce family size.
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PMID:Child labour in Egypt. II. Impact of work environment on health. 1726 56


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