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

Microsurgical technique was applied in 46 cases of lumbar disc herniation in the years 1993-1994. The group comprised 17 women and 29 men aged 17-46 years (mean age 39.54 +/- 8.72). Sciatic pain was present in 39 (85%) cases, in the remaining ones low back pain was the main symptom. Neurological deficit signs were noted in 21 (46%) cases. The authors discuss the indications to microdiscectomy, the microsurgical technique and outcomes. Microdiscectomy was carried out in cases selected strictly according to the result of neurological examination and radiological findings X-ray of lumbosacral region in 46 cases (100%), myelography in 11 (24%), CT in 4 (9%) and MRI in 31 (67%). MRI served for evaluation of signal intensity, site and site of disc hernia. In 31 cases the operation was done in patients with recognized unilateral and one-level disc hernia. Full remission of complaints was noted in 45 patients during follow-up over 2 years.
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PMID:[Lumbar disk herniation treated by microsurgery]. 1046 52

A 59-year-old female patient with mitral valve prolapse and a previous history of lumbosacral spondyloarthrosis and lumbar disk hernia had an episode of infective endocarditis due to Streptococcus viridans, which evolved with peripheral embolism to the left kidney, spleen, and left iliac artery, and intraventricular cerebral hemorrhage. Her clinical manifestations were low back pain and hematuria, which were initially attributed to an osteoarticular condition. Infective endocarditis is a severe polymorphic disease with multiple clinical manifestations and it should always be included in the differential diagnosis by clinicians.
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PMID:Multiple embolism in a female patient with infective endocarditis. Low back pain and hematuria as the initial clinical manifestations. 1218 59

There are numerous etiologies to low back pain. Even if the degenerative origin is the most frequent one, other possible aetiologies have to be kept in mind. Inflammatory low back pain is encountered in the young patient, appearing at night and can be associated with extra-spinal symptoms (e.g. psoriasis, M. Reiter, etc.). The lumbar spine is rarely involved in chronic polyarthritis. In case of tumors, the metastasis is the most frequent cause whereas the plasmocytoma is the most frequent primitive bone tumor of the spine. Infectious diseases can be of hematogenous origin or by direct iatrogenic inoculation. Surgical treatment is indicated in case of inefficient medical treatment or if there is a risk of neurologic compromise or instability. Low back pain of metabolic origin is related to osteoporosis. Pain is secondary to vertebral compression fractures which makes it come close to post-traumatic low back pain caused by static disorders. Finally, in most cases low back pain is has a degenerative origin. The degenerative disease is dominated by the disc degeneration, primum movens of the degenerative disease. Alteration of the mechanical properties of the disc leads to degenerative arthritis in the intervertebral joints by modifying their motion pattern. These changes can lead to osteophytes which can, together with the narrowing of the disc space lead to a narrowing either of the foramen intervertebrale or the spinal canal (acquired lumbar stenosis). Treatment is nonoperative first except in urgent situations (conus cauda syndrome, disc hernia with paresia).
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PMID:[Etiologies of lumbago]. 1460 81

At the Orthopaedics and Traumatology Unit of the Palmanova Hospital, between 27 October 1989 and 31 December 2003 we performed 506 automated percutaneous nucleotomies according to Onik for the treatment of lumbar disc hernia. The survey of 50 reviewed cases after evaluation of the subjective and objective clinical pictures according to the Cabot method allowed us to come to the conclusion that this percutaneous methodology is suitable to relieve damaged discs from compression. It is also well accepted by patients because it is not too traumatic, it requires short-term hospitalisation, presents no risk of post-operative fibrosis and does not create complications for the eventual traditional operation when unsuccessful. It is extremely important to accurately select the candidates keeping in mind the original indications given by Onik for percutaneous discectomy for which--in case of contained disc herniation--leg pain (sciatalgia) is more severe than low back pain affecting the lumbar region.
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PMID:A long-term review of 50 patients out of 506 treated with automated percutaneous nucleotomy according to Onik for lumbar-sacral disc herniation. 1583 Sep 78

This prospective, non-randomized clinical trial was designed to determine the clinical outcome of patients who underwent Intradiscal Electrotherapy (IDET) for the treatment of chronic discogenic low back pain. Twenty-seven consecutive patients undergoing IDET were prospectively evaluated. All patients, as determined by provocative discography and/or MRI, had discogenic disease with chronic low back pain and were non-responsive to conservative treatment for at least 6 months. The mean pre-operative duration of symptoms was 38 months. The American Association of Neurological Surgeons/Congress of Neurological Surgeons Joint Section Lumbar Disc Herniation Study Questionnaire, which includes the Oswestry Low Back Pain Disability Questionnaire and the Short Form (SF) -36 Health Status Questionnaire, was used. The follow-up endpoint for all patients was one year. Seventy-five percent of patients improved based upon the Oswestry Low Back Pain Disability Questionnaire while only 48% of patients were found to improve on the SF-36 Survey. The SF-36 Bodily Pain Subscale did improve relative to other subscales in 52% of patients. There was no relationship found between outcome and duration of symptoms (p= .32), number of levels treated (p= .20), or worker's compensation (p= .38). There were no complications that resulted from the IDET treatment. IDET was found to be effective in 75% of patients in improving their chronic low back pain. This did not translate into a significant improvement in the SF-36 survey scores. The risks are negligible, and recovery time is minimal. The procedure may be useful in selected patients who would otherwise undergo an interbody fusion procedure.
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PMID:A prospective outcomes study of patients undergoing intradiscal electrothermy (IDET) for chronic low back pain. 1688 13

Herniation of the lumbar disc is a common cause of low back pain. Conservative management with physiotherapy, such as lumbar spine traction, is usually effective. Although a schwannoma of the lumbar spine is relatively uncommon, the clinical manifestations are similar to those of lumbar disc herniation, making the diagnosis difficult. This case report describes a 51-year-old male who had suffered from low back pain for 3 years and who was diagnosed with L2/L3 lumbar disc herniation. The low back pain was well-controlled by conservative treatment and the symptoms improved progressively. Two months prior to our evaluation, however, the symptoms worsened acutely, and were accompanied by the onset of symptoms of cauda equina syndrome. A small tumor at the site of the L2/L3 disc herniation, observed incidentally during magnetic resonance imaging, was responsible for the symptoms of spinal stenosis at the lumbar region. The patient underwent laminectomy, tumor resection, and discectomy with near-complete resolution of symptoms. In patients with lumbar disc herniation that improves with conservative treatment, the recurrence of symptoms should prompt a thorough review of the medical history, physical examination, and imaging studies to establish the diagnosis and prevent delay in treatment.
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PMID:Exacerbation of symptoms of lumbar disc herniation complicated by a schwannoma: a case report. 1776 18

Low back pain (LBP) and shoulder and arm disorders are common among workers exposed to risk due to manual weight lifting, and this health care problem is also very costly. We also know that nursing personnel exposed to manual patient handling activity report high number of work-related musculoskeletal disorders. The objective of our study was to evaluate the relationships between work and musculoskeletal disorders in personnel exposed to manual patient handling activity. 160 health care workers of an hospice exposed to patient handling were compared to a control group of 172 people not exposed to the handling risk. In our study we considered only subject with pathology already diagnosed, withdrawing people with disturbs but without clinical trials. The statistical evaluation using the chi2 test has not shown any meaning in the comparison between the two groups, we have calculated the Odds Ratio risk for discal hernia and protrusion finding a risk between low and modest (1.52). We think that the least prevalence of musculoskeletal disorders to the back in the group exposed to manual patient handling activity, could be explained partly with the "healthy worker" effect and partly with the workplace improvement. That is demonstrated also with the M.A.P.O. index scoring between 0 and 1.5 (negligible risk).
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PMID:[Evaluating patients manual handling hazards in nursing personnel of a hospital]. 1840 35

Lumbar discectomy is a very effective therapy for neurological decompression in patients suffering from sciatica due to hernia nuclei pulposus. However, high recurrence rates and persisting post-operative low back pain in these patients require serious attention. In the past decade, tissue engineering strategies have been developed mainly targeted to the regeneration of the nucleus pulposus (NP) of the intervertebral disc. Accompanying techniques that deal with the damaged annulus fibrous are now increasingly recognised as mandatory in order to prevent re-herniation to increase the potential of NP repair and to confine NP replacement therapies. In the current review, the requirements, achievements and challenges in this quickly emerging field of research are discussed.
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PMID:Repair, regenerative and supportive therapies of the annulus fibrosus: achievements and challenges. 1910 50

Intraradicular lumbar disc herniation is a rare complication of disc disease that is generally diagnosed only during surgery. The mechanism for herniated disc penetration into the intradural space is not known with certainty, but adhesion between the radicular dura and the posterior longitudinal ligament was suggested as the most important condition. The authors report the first case of an intraradicular lumbar disc herniation without subdural penetration; the disc hernia was lodged between the two radicular dura layers. The patient, a 34-year-old soldier, was admitted with a 12-month history of low back pain and episodic left sciatica. Neurologic examination showed a positive straight leg raising test on the left side without sensory, motor or sphincter disturbances. Spinal CT scan and MRI exploration revealed a left posterolateral osteophyte formation at the L5-S1 level with an irregular large disc herniation, which migrated superiorly. An intradural extension was suspected. A left L5 hemilaminectomy and S1 foraminotomy were performed. The exploration revealed a large fragment of disc material located between the inner and outer layers of the left S1 radicular dura. The mass was extirpated without cerebrospinal fluid outflow. The postoperative course was uneventful. Radicular interdural lumbar disc herniation should be suspected when a swollen, hard and immobile nerve root is present intraoperatively.
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PMID:Radicular interdural lumbar disc herniation. 1988 8

Sacroiliac joint (SIJ) can cause low back pain when its joint capsule and ligamentous tissue are damaged. We report our experience in treating three SIJ dysfunction patients presenting with acute low back pain (a 38 year-old male, a 24 year-old male, and a 32 year-old female). SIJ dysfunction was diagnosed using the one-finger test, the modified Newton test, and SIJ injection. In all three patients, lumbar MRI demonstrated slightly degenerated lumbar lesions (lumbar canal stenosis, lumbar disc hernia). Two patients had paresthesia or pain in the leg and all three patients showed iliac muscle tenderness in the groin, which was thought to be a referred symptom because of improvement after SIJ injection. The two male patients returned to work and the problems have not recurred. Although our female patient resumed daily life as a housewife, her condition recurred at intervals of 2-3 months and she required regular SIJ injections. The prevalence of SIJ dysfunction of low back pain is about 10%, so it should be considered as a differential diagnosis when treating low back pain and designing treatment for lumbar spinal disorders.
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PMID:[Sacroiliac joint dysfunction presented with acute low back pain: three case reports]. 2062 93


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