Intervertebral Disc Lesions Research Articles

Low Back Injuries in Nursing Staff

A prospective survey extending over 5 years of 180 low back injuries to nursing staff causing absence from work in one health district employing 3778 nurses is described. The risk of injury is assessed in relation to the length of absence from work and consequent disability. Of the injuries, 27 per cent resulted in a prolapsed intervertebral lumbar disc lesion and 12 per cent of the injured nurses had their employment terminated on medical grounds as a result of the injury. The relevance of age, height, sex, rank and history of previous back injury are discussed but only a history of previous injury is considered to be of predictive value. The importance of training, type of lift. and pre-employment screening are described as measures which have resulted in a reduction of the number of nurses injured.

Paraplegia due to intervertebral disc lesions: a review of 57 operated cases.

In a review of 57 cases of paraplegia due to surgically confirmed disc protrusion (representing 0.9 per cent of all admissions to the National Spinal Injuries Centre), seven were in the cervical, 31 in the dorsal and 19 in the lumbar regions. Patients with dorsal disc protrusions treated by laminectomy had the worst neurological outcome. A recent decline in the incidence of neurological dysfunction following disc excision is noted and its probable causes discussed.

Bladder neuropathy in lumbar disc disease.

Disturbances of bladder, function often occur in cases of sciatica due to intervertebral disc lesions, although other clinical signs of sacral root compression are absent. In 32 patients, operated upon because of lumbar disc diseases without cauda equina syndrome, micturition symptoms were registered, and bladder function was investigated. Intravesical pressure/volume relations (water cystometry) and simultaneous intravesical pressure/urinary flow relations (urodynamic examination) were recorded preoperatively together with anal sphincter surface EMG. In almost half of the patients cystometry revealed bladder hyposensibility (late first sensation), and a quarter voided mainly by straining (detrusor paresis). These findings were unrelated to the neurosurgical pathology. Pronounced micturition symptoms or abnormal preoperative urodynamic examinations indicated evaluation two months after lumbar disc operation. Two-thirds tended towards recovery, one third remained unchanged.

An Analysis of the Water Soluble Contrast Myelography

The clinical usefulness of the myelography employing water soluble contrast materi al for the evaluation of lumbar disc derangement is well established here in Japan.With the above method, we scrutinize 226 cases out of a total of 235 patients with the intervertebral disc lesion from April 1973 to August 1977.The type exhibiting the root compression occupies as much as 57% of the entire cases in our study and we feel often great embarrassment at the decision of surgical or palliative management of this type of derangement.

THE MANAGEMENT OF INTERVERTEBRAL DISC LESIONS

Medical Journal of AustraliaVolume 2, Issue 25 p. 843-843 Correspondence THE MANAGEMENT OF INTERVERTEBRAL DISC LESIONS First published: 01 December 1977 https://doi.org/10.5694/j.1326-5377.1977.tb99347.xAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Volume2, Issue25December 1977Pages 843-843 RelatedInformation

Anterior intervertebral disc herniations in children Report of four cases

Four boys with anterior lumbar disc herniations probably secondary to chronic trauma are reported. Anterior disc herniations may appear as separate lesions-as in our patients-or coexist with Scheuermann's disease. Although Scheuermann's disease, discitis and tuberculosis are regarded as the most common causes of intervertebral disc lesions in childhood, trauma should be excluded as a possible cause in all children with chronic back pain who show localised radiographic signs of narrowed disc spaces with erosive and sclerotic changes in the adjacent vertebrae. Localised mild platyspondly may be the result of abnormal, prolonged stress and early osteoarthritic changes are to be expected.

Orthopaedics Treatment of lumbar intervertebral disc lesions by intradiscal instillation of pressure reducing substances: A. Ortop., 113 (1975) 1031–1038

Orthopaedics Treatment of lumbar intervertebral disc lesions by intradiscal instillation of pressure reducing substances: A. Ortop., 113 (1975) 1031–1038

Conservative treatment of intervertebral disc lesions and "whiplash" injuries.

Conservative treatment of intervertebral disc lesions and "whiplash" injuries.

In Vitro Inhibition of Leucocyte Migration in Patients with Intervertebral Disc Lesions

Summary Patients with the prolapsed intervertebral disc syndrome were examined for sensitization to autologous intervertebral disc extract using the leucocyte migration inhibition test. Three patients of 12 studied 10 to 14 days after discectomy showed inhibition of leucocyte migration. All three patients had sequestrated protruded discs. None of the eight patients with disc protrusion and no sequestration gave a positive reaction. In one patient who was studied in detail, inhibition of leucocyte migration occurred in the presence of disc extract from another, nonsensitized patient. It was found that leucocyte migration was inhibited strongly and nonspecifically by disc extracts in high concentration. This nonspecific effect could be eliminated by dilution.

The New Operation Technic of the Lesions of Lumbar Intervertebral Discs

While the question as to wheather the lumbosacral spine should be fused operatively following the removal of the herniated disc by posterior approach is still a controversial one, there is a coincidental opinion among most authors that the added vertebral fixation operation is necessary to get a good result for those cases in which the marked degeneration of one or more intervertebral discs, or obvious instability exists.Several problems have been pointed out as disadvantageous for these previous methods of vertebral fixation. These are as follows:1. Fusion of span is frequently found to be incomplete.2. Vertebral is necessary in principle and secondary spondylolysis is apt to occur above the fixed vertebrae as the postoperative complication.3. Fixation is necessary for a moderately long time.4. Affection of operation is not slight.To resolve these problems, we have altered the method of vertebral fixation after Langenskiöld (1967) and we consider this new method as a reliable one to recommend, because of the possibility of early rehabilitation and the rather slight operative affection. Combined method of lumbar disc hernia enucleation followed with posterior vertebral fixation.

A comparison between epidural anaesthesia with and without corticosteroid in the treatment of sciatica.

SUMMARY: Comparison of the results of treatment with epiduralinjection of procaine alone with that of procaine plus Depo-Medrone in patients with unilateral sciatica showed no definite difference between the two groups. Of 48 patients, there was improvement in about 70 %, whichever solution was used. However, it is of interest that in patients with a long history of severe sciatica the injection of procaine plus Depo-Medrone appeared to give better results. This finding should be noted, and a further comparative trial in this group is worth undertaking. LUMBAR disc lesions with nerve-root compression are common, and epidural injections have been used therapeutically, with alleged benefit, for many years (Cathelin, 1901; Viner, 1928; Evans, 1930). During the last ten years, epidural injections of local anaesthetic (Coomes, 1961; Cyriax, 1969), corticosteroid (Barry and Kendall, 1962; Harley, 1967), or saline (Davidson, 1961), separately or in combination (Goebert, 1960; Brown, 1960; Goldie, 1968), have attracted some interest. Previous papers have produced claims for the effectiveness of these preparations. In particular, there has been a suggestion that injection of corticosteroid is of special benefit. The object of this paper is to compare the results, in patients with sciatica, of epidural injection of procaine alone with those of injection of procaine plus Depo-Medrone, and to show, from a practical point of view, if it is worth while adding a corticosteroid to the local anaesthetic solution. To my knowledge, no previous comparison has been recorded. MATERIAL Forty-eight consecutive patients were treated with epidural local anaesthesia during the past six months; 36 were males and 12 females. The ages ranged from 19 to 71 years, with a mean of 40 · 6 years. Patients were selected with moderate or severe unilateral sciatica, thought to be caused by an intervertebral disc lesion, with or without neurological signs, before or after other conservative treatments

A REAPPRAISAL OF INTERVERTEBRAL DISC LESIONS

Medical Journal of AustraliaVolume 1, Issue 24 p. 1229-1229 Correspondence A REAPPRAISAL OF INTERVERTEBRAL DISC LESIONS First published: 01 June 1970 https://doi.org/10.5694/j.1326-5377.1970.tb84540.xAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Volume1, Issue24June 1970Pages 1229-1229 RelatedInformation

Inflammatory Lesions of Intervertebral Discs in Children

Twenty cases of inflammatory lesions of the intervertebral disc in children have been reviewed. This is a benign condition of unknown but presumed infectious etiology. Serial roentgenograms have revealed a consistent pattern of vertebral involvement with later partial restoration of the disc height. Roentgenograms including laminagrams made at follow-up have demonstrated persistent cavitation and varying degrees of vertebral overgrowth. The management of this condition, including the controversial roles of biopsy, antibiotic therapy, and spinal immobilization, has been discussed.

TREATMENT OF LUMBAR INTERVERTEBRAL DISC LESIONS BY DIRECT INJECTION OF CHYMOPAPAIN

1. An account of experiences in seventy-five cases with a new method of treatment of low back pain and sciatica caused by intervertebral disc lesions has been presented. The method is based on the fact that chymopapain, a proteolytic enzyme, can break down displaced intervertebral disc material without deleterious effects upon adjacent tissues. 2. Chymopapain was injected into intervertebral discs by the postero-lateral or preferably the lateral approach. Two milligrams per disc constitute an effective dose. The enzyme was administered to seventy-five patients who were potential candidates for laminectomy. These patients were followed for four to thirty months and results were graded as "good" (76 per cent), "fair" (15 per cent) and "poor" (9 per cent). 3. Although untoward reactions have been encountered, none of these has been attributable to chymopapain. 4. Our investigations have convinced us that enzymatic dissolution of a lumbar intervertebral disc lesion is a safe, effective method of relieving sciatica and low back pain in selected cases.

Evaluation of Myelography in Diagnosis of Lumbar Intervertebral Disc Lesion

Evaluation of Myelography in Diagnosis of Lumbar Intervertebral Disc Lesion

Correlation of the Myelogram with Clinical and Operative Findings in Lumbar Disc Lesions

1. An analysis is presented of 866 patients who, during the past twelve and a half years, had myelography as part of the diagnostic study by the orthopaedic surgeons at Barnes Hospital for a lumbar intervertebral disc lesion; surgical exploration of the lumbar area was then performed. 2. At operation, 625 positive and thirty-seven negative myelograms were confirmed, giving an accuracy of 76.4 per cent. 3. Major discrepancies were noted in 150 (17.3 per cent) cases. 4. Relatively unimportant or minor discrepancies were present in fifty-four cases (6.2 per cent). 5. Six extradural and three intradural neoplasms masquerading as ruptured intervertebral disc lesions occurred in this series of 866 patients, representing an incidence of 1 per cent. Even with myelograms only two intradural tumors out of the total of nine neoplasms were diagnosed definitely before operation. 6. In cases in which operation for a lumbar disc lesion is clearly indicated on the basis of the clinical picture and lack of response to conservative treatment, a negative myelogram should not prevent the surgeon from exploring the lumbar spinal canal. 7. Myelography can be a valuable aid in diagnosis and may be very helpful in borderline cases. We now believe that myelography should routinely precede surgery for lumbar disc lesions. 8. In our opinion a lumbar myelogram should not be done when a ruptured lumbar intervertebral disc is suspected unless surgical treatment is being considered.

Intervertebral disc removal and spine fusion

We have concluded that a spine fusion procedure should be performed upon all patients from whom a ruptured or herniated intervertebral disc is removed. Most patients with simple disc excision will undergo subsequent degenerative changes in the facet joints of the lumbar spine. We have been unable to arrive at any reliable criteria for differentiating among those patients who will not need spine stabilization and those in whom back pain will be so incapacitating that a second operation for spine stabilization should be performed. One hundred fifty-four of our patients with herniated intervertebral disc lesions requiring surgical intervention were reviewed, and in 120 patients the end results were studied. Of this group of 120, 44.1 per cent had excellent results, 26.6 per cent had good results, 17.5 per cent were satisfactory, and 11.8 per cent poor. The number of patients complaining of any residual back pain in the entire group was 17 per cent. In our cases an added spine stabilization procedure has not shown any increased incidence of morbidity as compared to the simple procedures. The patients averaged 18.4 days in the hospital, which is not a marked increase over those in whom only a simple disc excision is performed. In most patients the length of time away from productive employment is also not materially lengthened over that when only the simple procedure is performed. The results are far from perfect, but with increased attention to the finer details of spine fusion technic they can be improved. Although some of our patients exhibit a pseudarthrosis, these spines are remarkably stable due to dense fibrous tissue formation resulting in a decrease in back pain. Surgeons who evaluate end results on a basis of relief of sciatica alone tend to ignore a major disability factor. Backache is the cause of more chronic disability than nerve pain from sciatica. No end result study can be accepted unless it is based on an evaluation at least four to five years after surgery. Patients who have had a disc removed and later require a fusion dread the second operation much more than the first, and all degrees of anxiety and psychoneurosis are seen in these patients. Pantopaque, although believed to be rapidly absorbed in the subarachnoid space, was found to be present in significant amounts as long as ten years after myelography. However, no significant reactions were noted to the prolonged presence of the pantopaque media.

LESIONS OF THE CERVICAL INTERVERTEBRAL DISC. By R. Glen Spurling, M.D., Professor of Neurosurgery, University of Louisville School of Medicine, Louisville, Kentucky. 9½x6 in. Pp. xi+134, with 41 figures and 3 tables. Index. 1956. Springfield, Illinois: Charles C. Thomas, Publisher. Oxford : Blackwell Scientific Publications. Price 36s

LESIONS OF THE CERVICAL INTERVERTEBRAL DISC. By R. Glen Spurling, M.D., Professor of Neurosurgery, University of Louisville School of Medicine, Louisville, Kentucky. 9½x6 in. Pp. xi+134, with 41 figures and 3 tables. Index. 1956. Springfield, Illinois: Charles C. Thomas, Publisher. Oxford : Blackwell Scientific Publications. Price 36s

Myelographically demonstrated lesions of the cervical intervertebral discs, co-existing with tumors and other causes of myelopathy.

Myelographically demonstrated lesions of the cervical intervertebral discs, co-existing with tumors and other causes of myelopathy.

Myelographically Demonstrated Lesions of the Cervical Intervertebral Discs, Co-Existing with Tumors and other Causes of Myelopathy

Myelographically Demonstrated Lesions of the Cervical Intervertebral Discs, Co-Existing with Tumors and other Causes of Myelopathy