Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0235394 (wasting)
 8,040 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

One hundred patients with lumbar disc protrusions were studied. Thirty six "control" patients were admitted in the same time period with low back pain and sciatica but with subsequently "normal" myelograms and no surgery. The aim of this paper was to relate history and clinical signs to the myelograms and surgical findings. Ninety nine per cent of our patients presented with sciatica (controls 94%). The most frequently found sign in patients with a disc protrusion was reduction of ipsilateral straight leg raising (98%). However, 55% of controls also showed this sign. There were three signs that, when present, particularly indicated a disc protrusion; "crossed straight leg raising" (pain on contralateral straight leg raising), measured calf wasting and impaired ankle reflex: the latter being especially indicative of an L5-S1 disc protrusion. There were two further important signs, weakness of dorsiflexion of the foot and scoliosis of the lumbar spine. However, such signs occurred in about half the patients and so clinical diagnosis in the remaining half depended on obtaining a good history of sciatica, and paying due regard to severity of the pain, the mobility of the patient, the ability and desire to work and the overall personality. Satisfactory results of surgery simply depend on finding and removing a definite disc protrusion. Using these methods of selection, 98% have returned to their original employment, 86% within 3 months of the operation. For a patient with no abnormal signs and a normal myelogram, surgical treatment should not be advised.
 ...
PMID:The value of accurate clinical assessment in the surgical management of the lumbar disc protrusion. 334 82

The effect of low back pain on the size of the lumbar multifidus muscle was examined using real-time ultrasound imaging. Bilateral scans were performed in 26 patients with acute unilateral low back pain (LBP) symptoms (aged 17-46 years) and 51 normal subjects (aged 19-32 years). In all patients, multifidus cross-sectional area (CSA) was measured from the 2nd to the 5th lumbar vertebrae (L2-5) and in six patients, that of S1 was also measured. In all normal subjects, CSA was measured at L4 and in 10 subjects measurements were made from L2-5. Marked asymmetry of multifidus CSA was seen in patients with the smaller muscle being on the side ipsilateral to symptoms (between-side difference 31 +/- 8%), but this was confined to one vertebral level. Above and below this level of wasting, mean CSA differences were < 6%. In normal subjects, the mean differences were < 5% at all vertebral levels. The site of wasting in patients corresponded to the clinically determined level of symptoms in 24 of the 26 patients, but there was no correlation between the degree of asymmetry and severity of symptoms. Patients had rounder muscles than normal subjects (measured by a shape ratio index), perhaps indicating muscle spasm. Linear measurements of multifidus cross-section were highly correlated with CSA in normal muscles but less so in wasted muscles, so CSA measurements are more accurate than linear dimensions. The fact that reduced CSA, i.e., wasting, was unilateral and isolated to one level suggests that the mechanism of wasting was not generalized disuse atrophy or spinal reflex inhibition.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Evidence of lumbar multifidus muscle wasting ipsilateral to symptoms in patients with acute/subacute low back pain. 815 25

We observed seven patients who developed their first signs and symptoms of motor neuron disease together with signs of protrusion/prolapse of intervertebral disc. The age of the patients was between 55 and 67, of which one female and six male patients. All of them suffered from cervical spine pain or low back pain. The female patient and one male patient developed weakness in the small feet muscles as initial symptom and they complained of paresthesia along dermatomes L5S1 and of severe pain. The other five patients developed wasting of the hands muscles. They had a rather mild pain in the cervical spine and early morning paresthesia as well as severe causalgia along dermatomes C5C6 or C6C7. After the diagnosis of compressive radiculopathy in all patients, they underwent surgical treatment and very soon developed very severe progression of muscle wasting which included muscles of limbs, trunk and bulbar innervated muscles with signs and symptoms of lower and upper motor neuron lesion. Five patients died from 12 to 15 months after surgical treatment and two patients are still living.
 ...
PMID:Severe progression of ALS/MND after intervertebral discectomy. 985 48