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Query: UMLS:C0033377 (prolapse)
 11,717 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Observations on a series of 38 cases (35 Doberman Pinschers and three Great Danes) of the canine wobbler syndrome are described. Radiographic examinations suggested that the primary lesion is an intervertebral instability at C6/7, but with time, secondary changes of the disc degeneration and prolapse and vertebral body malformation causing stenosis of the vertebral canal occur. Cases detected at a young age and showing only the primary lesion were treated successfully, by disc fenestration alone or by disc fenestration and intervertebral screwing. The success rate in older cases with secondary lesions was poor and in this type of case, cord decompression by dorsal laminectomy appears necessary.
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PMID:Cervical vertebral instability (wobbler syndrome) in the dog. 45 50

The fourth lumbar vertebrae and L4-5 discs from six cadaveric lumbar spines were subjected to detailed strain gauge analysis under conditions of controlled loading. With central compression loads, maximal compressive strain was found to occur near the bases of the pedicles and on both superficial and deep surfaces of the pars interarticularis, which emphasises the importance of the posterior elements of lumbar vertebrae in transmitting load. Radial bulge and tangential strain of the disc wall were maximal at the posterolateral surface, in agreement with the fact that disc degeneration and prolapse commonly occur there. Under posterior offset loads simulating extension, both compressive and tensile strains were found to be increased on both surfaces of the pars interarticularis, which suggests that hyperextension may lead to stress fractures and spondylolisthesis. Posterior offset loads also increased the radial bulge of the posterior disc wall and tangential strain at the anterior surface of the disc. Anterior offset loads simulating flexion increased the radial bulge of the anterior disc wall and tangential strain at the posterior surface of the disc. These findings are compatible with movement of the nucleus pulposus within the disc during flexion and extension. This hypothesis was supported by post-mortem discography.
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PMID:The distribution of surface strain in the cadaveric lumbar spine. 65 74

There are no detailed data in literature concerning the histologic nature of the sequestered (extruded) lumbar disc, and on the frequency with which an extruded fragment, a prolapse or a protrusion are found at surgery. A prospective analysis of 100 consecutive cases of sequestered lumbar disc herniation submitted to surgical treatment revealed this group to represent 28.6% of all cases operated on for lumbar disc herniation. Patients (both male and female) with sequestered lumbar discs are significantly older than those with prolapsed (P < 0.01) and protruded (P < 0.001) discs. Single extruded fragments (n = 68) were twice as frequent as multiple ones (n = 32). The general belief that a 'sequestered (extruded) disc' is almost invariably composed of nucleus pulposus is not substantiated by this study: In 54 cases the extruded fragment consisted predominantly of nucleus material, whereas in 44 cases it consisted mainly of end-plate material. Multiple as well as recurrent sequestered fragments almost always consist of end-plate material. These findings may reflect the result of metabolic alterations in the course of disc degeneration.
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PMID:The form and structure of the extruded disc. 147 Oct 3

The lumbar spine magnetic resonance (MR) studies in 246 consecutive patients who suffered from persistent back and leg pain were evaluated for the degree of degenerative disc disease and the presence of disc bulging, prolapse, or herniation. No patient had a history of previous back surgery. In those patients, degenerative disc changes increased with age until the fifth decade of life, after which a relatively similar proportion of patients had degenerative disc disease. Significant dehydration and degeneration occurred in less than 5% of the upper two disc spaces while L4/5 and L5/S1 had marked changes in greater than 20%. Prolapse and herniation progressively increased with each lower interspace, where at L5/S1 it was present in nearly one-third of the patients. Although a few patients had disc prolapse or herniation with a nondegenerated disc, there was a relationship between the presence of disc degeneration and prolapse or herniation.
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PMID:Magnetic resonance assessment of the distribution of lumbar spine disc degenerative changes. 285 24

The syndrome of 'benign thoracic pain' is seen in young women who have pain and tenderness in the mid-thoracic spine radiating around the chest and aggravated by spinal movement. Ten consecutive patients with this syndrome and 15 controls were evaluated with magnetic resonance imaging (MRI). This showed thoracic intervertebral disc dehydration with no associated prolapse in 90% of the patients and 13% of the controls. We postulate that the clinical features are due to impaired shock absorption of these degenerate discs rather than direct compression of surrounding structures. MRI is non-invasive and does not use ionizing radiation; it allows direct visualization of the entire thoracic spine and cord, and accurate detection of early disc degeneration. Thus, it is the imaging modality of choice for defining the subtle intervertebral disc abnormalities that characterize the 'benign thoracic pain' syndrome.
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PMID:'Benign thoracic pain' syndrome: role of magnetic resonance imaging in the detection and localization of thoracic disc disease. 292 69

Cadaveric lumbar intervertebral joints were loaded simultaneously in torsion and compression, and load-deformation curves were obtained. These were repeated after each of the following structures were cut through in turn: the supra/interspinous ligaments, the apophyseal joint in compression, and the apophyseal joint in tension. From the differences in the curves, it was possible to deduce the role of each structure and of the intervertebral disc in resisting and limiting torsion. The results show that torsion of the lumbar spine is resisted primarily by the apophyseal joint that is in compression, although the intervertebral disc does play a major role. The capsular ligaments of the tension facet and the supra/interspinous ligaments are unimportant. The compression facet is the first of rotation in joints with nondegenerated intervertebral discs. Much greater angles are required to damage the intervertebral disc, so torsion seems unimportant in the etiology of disc degeneration and prolapse.
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PMID:The relevance of torsion to the mechanical derangement of the lumbar spine. 726 44

The mechanical response of intervertebral joints is deeply influenced by disc degeneration. The phenomenon is expressed in terms of variations in the biomechanical properties of the material, whose compressibility characteristics change because of the liquid content loss in the tissue and, what is even more important, to prolapse. In this work, the problem is investigated by means of a computational mechanics approach; a coupled material and geometric non-linear model is developed, representing vertebra, annulus and nucleus submitted to an axial load. A transversely isotropic law is assumed for cortical bone in the vertebral body and an isotropic law for the cancellous portion; a hyperelastic formulation is assumed for the disc, allowing effective interpretation of the mechanical characteristics of degeneration. The results obtained are reported with regard to bony endplate and annulus behaviour; interaction phenomena between bony endplate and nucleus are emphasized.
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PMID:The mechanical behaviour of bony endplate and annulus in prolapsed disc configuration. 832 Sep 83

Fifty-four consecutive patients were studied prospectively with magnetic resonance imaging before microdiscectomy, and the findings correlated with clinical symptoms before and after operation. A sequestrated fragment was found in 59% of cases, a subligamentous disc sequestration in 25% and a disc protrusion in 16%. The levels operated on were L4/5-36%, L5/S1-62.5%, and one at L3/4; 71% were laterally placed, 10% lay intraforaminal and 10% medial. The diameter of the protrusion was 4 mm to 13 mm for the craniocaudal extension, and 5 mm to 18 mm for the anteroposterior extension. No correlation could be found between a neurological deficit and the size of the prolapse. A positive correlation was present between the increasing degree of canal obstruction and the degree of disc degeneration determined by imaging for extrusions, subligamentous disc sequestrations and free sequestrations. Nerve root inflammation and enlargement was seen in 36% of the images, corresponding to an operative finding of 32%. Magnetic resonance imaging is a helpful pre-operative diagnostic investigation which shows structural changes in the disc and the correct localisation and size of the disc sequestration, but there was no correlation between the imaging findings and the clinical symptoms.
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PMID:The correlation between magnetic resonance imaging and the operative and clinical findings after lumbar microdiscectomy. 979 11

To investigate the regenerative potential of human disc tissue, the disc samples were obtained during surgery from 24 adult patients with first lumbar prolapses and from 14 patients with recurrent lumbar prolapses. Preoperative magnetic resonance imaging (MRI) confirmed prolapse and disc degeneration in all cases. The proliferation activity of the sampled connective tissue cells was studied with the immunohistochemical expression of Ki-67(MIB-1) antigen. The antigen was positive in 6 of 24 (25%) specimens from first prolapse and in none of the 14 specimens from the recurrent prolapse. The amount of proliferative cells did not correlate to the degree of disc degeneration in MRI. Our results indicate that connective tissue cells in adult degenerative disc may show proliferation activity after the first herniation and thus regenerative potential. The enhanced matrix proliferation may not be a significant reason for recurrent prolapses because none of the recurrent disc specimen showed proliferation activity.
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PMID:Proliferation potential of human lumbar disc after herniation. 1007 51

According to many investigators, lumbar disc herniation is formed by the nucleus pulposus displaced to the vertebral canal through the cracks in the annulus fibrosus as a final result of disc degeneration. Specimens obtained during 187 disc surgeries were studied to identify the morphological nature of various forms of disc herniation, especially protrusion and prolapse. In 29% of cases the herniated part was annulus fibrosus and in 21.5% cases the annulus fibrosus was seriously involved. Simultaneously 308 autopsy specimens were studied. On gross examination the signs of degeneration were advanced in 82, and strongly pronounced in 42. In 15 specimens, aged 40 years or older, fibre bundles were reversed to normal convex orientation producing annulus fibrosus bulge. Microscopic examination showed pronounced myxomatous degeneration within the annulus fibrosus. In these circumstances, we believe that general opinion must be verified, because in some herniations the nuclei pulposus are not involved and herniations are solely prolapses of annulus fibrosus. So, the lumbar intervertebral disc herniation should be classified on the basis of histological examinations as a herniation of nucleus pulposus, herniation of annulus fibrosus or as a mixed type herniation where both disc elements are involved.
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PMID:Degenerated lumbar intervertebral disc. A morphological study. 1214 Aug 71


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