Clinical and radiological findings of nerve root herniation after discectomy of lumbar disc herniation.

The authors report 2 cases of nerve root herniation after discectomy of a large lumbar disc herniation caused by an unrecognized dural tear. Patients complained of the abrupt onset of radiating pain after lumbar discectomy. Magnetic resonance imaging showed cerebrospinal fluid signal in the disc space and nerve root displacement into the disc space.

Association study of fibroblast growth factor 2 and fibroblast growth factor receptors gene polymorphism in korean ossification of the posterior longitudinal ligament patients.

Objective: The aim of this study was to determine whether single nucleotide polymorphisms (SNPs) of fibroblast growth factor (FGF) 2 gene and fibroblast growth factor receptor (FGFR) genes are associated with ossification of the posterior longitudinal ligament (OPLL).

Methods: A total of 157 patients with OPLL and 222 controls were recruited for a case control association study investigating the relationship between SNPs of FGF2, FGFR1, FGFR2 and OPLL. To identify the association among polymorphisms of FGF2 gene, FGFR1, FGFR2 genes and OPLL, the authors genotyped 9 SNPs of the genes (FGF2 : rs1476217, rs308395, rs308397, and rs3747676; FGFR1 : rs13317 and rs2467531; FGFR2 : rs755793, rs1047100, and rs3135831) using direct sequencing method.

Histomorphometric analysis of the spine and femur in ovariectomized rats using micro-computed tomographic scan.

Objective: The purpose of this study was to evaluate the different patterns of bone loss between the lumbar spine and the femur after ovariectomy in rats.

Methods: Twenty-four female Sprague-Dawley rats underwent a sham operation (the sham group) or bilateral ovariectomy (the ovariectomized group). Four and eight weeks after operation, six rats from each of the two groups were euthanized.

Physical examination, magnetic resonance image, and electrodiagnostic study in patients with lumbosacral disc herniation or spinal stenosis.

Objective: To compare the clinical implications of electro-diagnostic study with those of magnetic resonance imaging in patients with lumbosacral intervertebral herniated disc or spinal stenosis.

Design: Retrospective study of clinical data.

Patients: Patients with lumbosacral intervertebral herniated disc or spinal stenosis, diagnosed by clinical assessment and magnetic resonance imaging (MRI), were selected.

Transforaminal percutaneous endoscopic lumbar discectomy: technical tips to prevent complications.

Transforaminal percutaneous endoscopic lumbar discectomy is regarded as an effective alternative to open discectomy. Remarkable technical evolution now enables selective endoscopic removal of an epidurally extruded disc fragment. As a result, the surgical indications for this technique are becoming broader.

Usefulness of carbon dioxide laser for recurrent lumbar disc herniation.

Objective: During revision microdiscectomy for recurrent lumbar disc herniation (rLDH), the major concerns are approach-related complications, including dural tear and nerve root injury, because of adhesion scars and granulation tissue along the previous laminotomy site. In revision microdiscectomy of rLDH, carbon dioxide (CO2) laser can enable precise dissection and removal of adhesion scar. The purpose of this study was to evaluate the clinical usefulness of CO2 laser dissection in patients who had undergone revision microdisectomy of rLDH.

Oblique paraspinal approach for thoracic disc herniations using tubular retractor with robotic holder: a technical note.

Introduction: Symptomatic thoracic disc herniations (TDHs) are uncommon and can be surgically treated. Although transthoracic decompression is considered the gold standard, it is associated with significant comorbidities. In particular, approach via a posterior laminectomy has been associated with poor results.

Laser-assisted posterior cervical foraminotomy and discectomy for lateral and foraminal cervical disc herniation.

Objective: Posterior cervical foraminotomy and discectomy (PCFD) is regarded as an effective treatment option for cervical radiculopathy. However, limited exposure of the disc space is one of its major disadvantages. To address this problem, we used a CO(2) laser for sophisticated decompression.

Sacral nerve stimulation through the sacral hiatus.

Sacral nerve stimulation through the retrograde approach has been used for peroneal or irritable bowel syndrome through the retrograde approach. However, several reasons, lead could not be advanced down ward. In this case, anterograde sacral nerve stimulation through the sacral hiatus could be used.

Clinical effectiveness of percutaneous adhesiolysis using Navicath for the management of chronic pain due to lumbosacral disc herniation.

Background: Epidural steroid injection has been frequently performed to treat chronic pain due to lumbosacral disc herniation (L-HIVD). However, a considerable number of patients do not achieve pain relief using this method because perineural or epidural adhesions prevent the spread of injectate into the epidural space. Percutaneous adhesiolysis (PA) is thought to be a useful method because it can eliminate the deleterious effects of adhesion.

Primary extensive spinal subarachnoid cysticercosis.

Study Design: A case report.

Objective: To describe a patient with a primary extensive spinal subarachnoid cysticercosis that was successfully treated with a combination of surgical removal and albendazole.

Summary Of Background Data: Neurocysticercosis (NCC) is the most common parasitic infection of the central nervous system.

Intradural invasion of lumbar synovial cyst. Case report.

A 63-year-old female presented with a rare case of synovial cyst invading the dura mater and mimicking an intradural extramedullary tumor in the lumbar spine. She underwent posterior lumbar fusion with laminar wire fixation from L3 to S1 levels. She complained of severe pain along the anterolateral thigh in both legs for 1 year.

Effect of intravenous lidocaine on the neuropathic pain of failed back surgery syndrome.

Background: An intravenous infusion of lidocaine has been used on numerous occasions to produce analgesia in neuropathic pain. In the cases of failed back surgery syndrom, the pain generated as result of abnormal impulse from the dorsal root ganglion and spinal cord, for instance as a result of nerve injury may be particularly sensitive to lidocaine. The aim of the present study was to identify the effects of IV lidocaine on neuropathic pain items of FBSS.

Management of cerebrospinal fluid leakage after anterior decompression for ossification of posterior longitudinal ligament in the thoracic spine: the utilization of a volume-controlled pseudomeningocele.

Study Design: Retrospective review

Objective: To determine the efficacy of management of cerebrospinal fluid (CSF) leakage after the anterior thoracic approach.

Summary Of Background Data: CSF leakage after incidental durotomy commonly occurs after anterior thoracic ossification of posterior longitudinal ligament (OPLL) surgery. Pseudomeningocele will invariably form under such circumstances.

A comparison study on the change in lumbar lordosis when standing, sitting on a chair, and sitting on the floor in normal individuals.

Objective: To compare radiographic analysis on the sagittal lumbar curve when standing, sitting on a chair, and sitting on the floor.

Methods: Thirty asymptomatic volunteers without a history of spinal pathology were recruited. The study population comprised 11 women and 19 men with a mean age of 29.

Postoperative spondylodiscitis following transforaminal percutaneous endoscopic lumbar discectomy: clinical characteristics and preventive strategies.

Introduction: We aimed to demonstrate the unique clinical characteristics and outcomes of spondylodiscitis after transforaminal percutaneous endoscopic lumbar discectomy (PELD), and we also discuss about adequate preventive methods of this unexpected complication.

Methods: The medical records of 9821 consecutive cases treated with PELD between January 2001 and December 2009 were reviewed. All cases of postoperative infection were identified.

Compatibility of the HINTEGRA prostheses with Korean ankles as evaluated on the basis of cadaveric measurements.

The purpose of this study was to obtain anatomical measurements of the distal tibia and talus of Korean ankles and to evaluate, based on those measurements, the compatibility of the HINTEGRA prostheses in the context of total ankle replacement (TAR). We measured the length, width, height, and angles of the distal tibia and talus of 51 cadavers and compared these measurements with the corresponding dimensions of the HINTEGRA prostheses. The male ankles were larger than the female ones as was expected, but their overall shapes did not differ, which fact validates use of the prostheses irrespective of patients' sex.

Prevention of development of postoperative dysesthesia in transforaminal percutaneous endoscopic lumbar discectomy for intracanalicular lumbar disc herniation: floating retraction technique.

Background: Transforaminal percutaneous endoscopic lumbar discectomy (PELD) has become a routine surgical procedure because it is minimally invasive. Perioperative complications such as dural injury, infection, nerve root irritation and recurrence can occur not only with PELD, but also with conventional open microsurgery. In contrast, post-operative dysesthesia (POD) due to existing dorsal root ganglion (DRG) injury is a unique complication of PELD.

Combined Anterior Approach with Transcorporeal Herniotomy for a Huge Migrated Cervical Disc Herniation.

The report describes the herniation of a huge migrated cervical disc, which was treated by a combined anterior approach. A 50-year-old man presented with radiculopathy and myelopathy. Radiological images revealed the herniation of a huge disc which had migrated superiorly from the C6-7 disc to the C5-6 disc.

Changes in the cross-sectional area of multifidus and psoas in unilateral sciatica caused by lumbar disc herniation.

Objective: To quantitatively evaluate the asymmetry of the multifidus and psoas muscles in unilateral sciatica caused by lumbar disc herniation using magnetic resonance imaging (MRI).

Methods: Seventy-six patients who underwent open microdiscectomy for unilateral L5 radiculopathy caused by disc herniation at the L4-5 level were enrolled, of which 39 patients (51.3%) had a symptom duration of 1 month or less (group A), and 37 (48.

Motor palsy after posterior cervical foraminotomy: anatomical consideration.

Background: Motor palsy is a serious complication that can result from cervical surgery. We introduced cases of motor palsy after posterior cervical foraminotomy (PCF) and consider cervical anatomy.

Methods: Between January 2007 and August 2010, 133 PCFs were performed on 106 consecutive patients with radiculopathy caused by foraminal stenosis or posterolateral disc herniation.

Changes in back pain after percutaneous endoscopic lumbar discectomy and annuloplasty for lumbar disc herniation: a prospective study.

Objective: Percutaneous endoscopic lumbar discectomy and annuloplasty (PELDA) is a minimally invasive spinal technique for lumbar disc herniation. Following discectomy, the relief of leg pain is common; however, the relief of back pain is less predictable. The purpose of this study was to evaluate changes in back pain and to examine the predisposing factors for postoperative back pain following PELDA.

Butterfly vertebra with lumbar intervertebral disc herniation.

A butterfly vertebra is a rare congenital anomaly that is usually asymptomatic. The authors, however, describe a novel case involving a butterfly vertebra overlapping with disc herniation that presented as radiculopathy. A butterfly vertebra is characterized by a symmetrical fusion defect resulting in a sagittal cleft vertebra.

Dural sac cross-sectional area does not correlate with efficacy of percutaneous adhesiolysis in single level lumbar spinal stenosis.

Background: Spinal stenosis is a narrowing of the spinal canal, which causes mechanical compression of spinal nerve roots. The compression of these nerve roots can cause low back pain and/or leg pain, as well as neurogenic claudication. Lumbar epidural steroid injections have commonly been used in patients with lumbar spinal stenosis (LSS).