共查询到20条相似文献,搜索用时 15 毫秒
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Tezer M Ozturk C Erturer E Aydogan M Hamzaoglu A 《The journal of spinal cord medicine》2006,29(4):430-435
BACKGROUND: The true incidence of osteoporotic vertebral fractures is not well defined because many osteoporotic vertebral fractures are asymptomatic. Although the true incidence of neurological compromise as a result of osteoporotic vertebral fractures is not known, it is thought to be low. In this case report, we present a case of L1 osteoporotic vertebral fracture causing bilateral L5 nerve root compression and manifestation of bilateral foot-drop. METHODS: Pedicle screws were inserted in the vertebrae, 2 above and 2 below the L1 vertebra. A temporary rod was placed on the left. An L1 right hemilaminectomy via a posterior approach and a corpectomy were performed. The spinal cord was decompressed. Anterior fusion was carried out by placing titanium mesh cage into the vertebrectomy site as a strut graft via posterior approach, and posterolateral fusion with spongious allografts were added to the procedure. RESULTS: Two years later the patient was completely symptom free and receiving medical treatment for osteoporosis, which was diagnosed as primary type. CONCLUSION: If a fracture is detected on the posterior wall of the vertebral body in computerized tomography (CT) examination with plain radiographs, a magnetic resonance imaging (MRI) examination should be conducted in the presence of symptoms and physical findings suggestive of neurological compression. Follow-up neurological examinations should be carried out, and it should be kept in mind that most of the neurological symptoms may develop late and manifest as radiculopathy. The majority of the osteoporotic vertebral fractures can be managed conservatively with bed rest and orthosis, but cases with accompanying neurological deficit should be managed surgically using decompression and stabilization by fusion and instrumentation. 相似文献
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磁刺激运动诱发电位在腰椎间盘突出所致的腰骶神经根病变中的应用研究 总被引:2,自引:0,他引:2
在35例有L5和/或S1神经根损害表现的腰椎间盘突出患者腰椎区进行磁刺激运动诱发电位(MEP)检查,测定、记录胫前肌、展肌和小趾展肌MEP的起始潜伏期(OL)。结果显示,35例中至少有一条总侧肌肉MEP异常33例(94.3%)。在L4-5椎间盘突出中,以胫前肌的MEP异常为主;在L5-S1椎间盘突出中,以小趾展肌的MEP异常为主。表明腰椎区MEP检查对腰椎间盘突出所致的腰骶神经根病变较为敏感,可为临床诊断提供可靠依据并有助于定位诊断。 相似文献
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Laurie King Silvano A Mior Kim Devonshire-Zielonka 《The Journal of the Canadian Chiropractic Association》1996,40(1):15-18
Lumbar spine disc herniations in children are a relatively rare condition reported to occur in less than 3% of those presenting with low back pain. Unlike the adult, the etiology and clinical picture often provides few clues to making the diagnosis. Although conservative management is the treatment of choice, surgical intervention may be required in some cases. The role of spinal manipulation in these cases may be of limited value. A case report is presented that illustrates the difficulty in making the diagnosis and conservatively managing lumbar disc herniations in children. 相似文献
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Koichiro Okuyama Tadato Kido Naohisa Miyakoshi Yoichi Shimada 《Acta orthopaedica et traumatologica turcica》2020,54(6):647
Vacuum phenomenon is a commonly observed radiological entity in the degenerated intervertebral discs of the lumbar spine in the elderly population. The entity is frequently asymptomatic. Although disc herniation containing gas (DH-CoG) is commonly associated with the vacuum phenomenon, DH-CoG associated with clinical symptoms is a rare condition. There are very few reports which have histologically demonstrated the existence of the gas itself within DH-CoG. Herein, we report a rare case of a 65-year-old female with symptomatic DH-CoG at L5/S1. The patient was admitted to our hospital with a one-month history of pain in the left buttock and leg in addition to neurogenic claudication. Roentgenograms illustrated a degenerative lumbar spine with the vacuum phenomenon at the L5/S1 disc space. Computed tomography showed a round and low-density lesion within the spinal canal at left L5/S1. Additionally, a lesion characterized by an iso- and partially hypointense signal on T1 and hypointense signal on T2 was detected in magnetic resonance imaging (MRI) by the spin-echo method. The decision for posterior lumbar interbody fusion surgery using pedicle screws was made as the symptoms had not responded to the conservative treatment. After a degenerated prolapsed nucleus was carefully extracted, the specimen was sent to the laboratory for histopathological analysis. The prolapsed nucleus of DH-CoG histologically showed many small vacuoles containing degenerated mucopolysaccharides. The left leg pain drastically resolved on the first post-operative day, and no recurrence had been observed. Degenerated mucopolysaccharide may be a precursor of nitrogen or “the gas itself” in DH-CoG. Surgical intervention for DH-CoG should be considered if conservative treatment fails. 相似文献
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BACKGROUND CONTEXT: This is a case report of a right posterolateral L5-S1 disc herniation that migrated to the left cephalad level to impinge on the left L5 nerve root as it exited the dura. The resultant free fragment migration is a rare variation of a posterolateral disc disruption. PURPOSE: The purpose is to report a rare variation of lumbar disc herniation not previously reported in the literature. STUDY DESIGN/SETTING: Case report. PATIENT SAMPLE: A 60-year-old white woman. OUTCOME MEASURES: Resolution of the patient's left lower extremity symptoms.METHODS: Not applicable. RESULTS: The patient experienced resolution of most of her left lower extremity symptoms after a slightly modified microscopically assisted lumbar hemilaminectomy, discectomy and nerve root decompression. CONCLUSIONS: This is a rare right to left migration of a sequestrated disc herniation, which was effectively treated with surgery. 相似文献
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BACKGROUND: Meralgia paresthetica, a syndrome of pain and/or dysesthesia in the anterolateral thigh, is normally caused by an entrapment of the lateral femoral cutaneous nerve (LFCN) at the anterior superior iliac spine. In a few cases compression of the nerve in the retroperitoneum has been reported to mimic meralgia paresthetica. CASE DESCRIPTION: A 67-year-old woman presented with a 5-year history of permanent paresthesia in the anterolateral thigh. Motor weakness was not detected. Electromyography showed a neurogenic lesion at the level of L3. Lumbar spine MRI detected a foraminal-extraforaminal disc herniation at L2/L3, which was extirpated via a lateral transmuscular approach. The patient was free of symptoms on the first postoperative day. CONCLUSION: In patients with meralgia paresthetica we emphasize a complete radiological investigation of the lumbar spine, including MRI, to exclude radicular compression by a disc herniation or a tumour at the level of L2 or L3. 相似文献
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《The British Journal of Chiropractic》2000,4(2-3):36-38
It is important for the chiropractor to be able to determine the nature of the pathology discovered on plain film radiography, and to suggest appropriate follow-up investigations, deemed to be clinically appropriate. This case demonstrates the value of plain-film radiography in diagnosing a rare sclerosing bone dysplasia, which in 10–15% of affected individuals is associated with articular pain and swelling. However, the demonstration of the lesions on CT is unusual, in so far as plain-film radiography is the gold standard by which to diagnose this condition. 相似文献
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Hidayet Akdemir M.D. I. Suat Oktem R. Kemal Koç Ikram Kavuncu 《Neurosurgical review》1997,20(1):71-74
An unusual case is presented in which a fragment of herniated lumbar disc was found within the sheath of the right S-1 nerve root. Diagnosis of intradural and intraradicular lumbar disc herniation is difficult, so that it is rarely suspected preoperatively. Surgical treatment results in a satisfactory clinical outcome. 相似文献
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Harrington JF 《Neurosurgery》2001,48(6):1377-9; discussion 1379-80
OBJECTIVE AND IMPORTANCE: Paramedial approaches to far lateral discs at the L5-S1 space joint have advantages but may also bring the surgical space closer to large branch arteries of the internal iliac artery. I report incursion into an iliolumbar artery that required laparotomy to control hemorrhage. Surgeons performing extraforaminal disc explorations at L5-S1 need to evaluate preoperative magnetic resonance imaging scans for an enlarged iliolumbar artery near the disc space. CLINICAL PRESENTATION: The patient presented with a right L5 radiculopathy and a far lateral disc at L5-S1, as indicated by analysis of her magnetic resonance imaging scan. INTERVENTION: A midline incision and an extraforaminal exposure were performed. Arterial bleeding occurred when an anular disc fragment was removed with a pituitary rongeur under direct vision with microscopic magnification. Emergency laparotomy demonstrated hemorrhage from a branch of the internal iliac artery 2 cm from its origin. CONCLUSION: Iliolumbar artery variants may be at the margins of extraforaminal disc exposure at L5-S1. Preoperative magnetic resonance imaging scans should be evaluated for this vasculature structure. 相似文献
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Osteoblastoma is an uncommon neoplasm of the bone accounting for only 0.5-2% of all primary bone tumors. It constitutes 9% of all primary bone tumors arising in the sacrum. The symptoms have a wide spectrum of variety and the diagnosis is often delayed. We report a case of sacral osteoblastoma in a 20-year-old man who presented with classical symptoms of postero-lateral herniation of L5-S1 vertebral disc. The clinical and radiographic findings are discussed as well as the surgical treatment. 相似文献
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目的前瞻性对比经皮椎间孔镜治疗L_(4-5)和L_5-S_1两个不同节段腰椎间盘突出症的临床效果。方法序贯性纳入经皮椎间孔镜治疗L_(4-5)和L_5-S_1腰椎间盘突出症患者各40例。临床评价指标包括手术时间、射线暴露时间、术后VAS、ODI评分改善程度及改良Mac Nab疗效评价。结果随访时间1年。L_(4-5)组手术时间为(91.0±18.1)min,L_5-S_1组为(114.5±17.7)min,差异有统计学意义(P0.05)。L_(4-5)组、L_5-S_1组评价射线暴露时间分别为(8.5±2.3)s和(16.9±2.3)s,差异有统计学意义(P0.05)。L_(4-5)组平均VAS改善程度为5.9±1.7,L5-S1组为5.5±1.5,差异无统计学意义(P0.05);而平均ODI改善程度则分别为20.2±4.0和19.6±4.4,差异无统计学意义(P0.05)。改良Mac Nab评价中,L_(4-5)组为优26例,良9例,可2例,差3例,优良率为87.5%;L_5-S_1组为优22例,良10例,可5例,差3例,优良率为80%,两组比较差异亦无统计学意义(P0.05)。结论:经皮椎间孔镜治疗单节段腰椎间盘突出L_5-S_1节段手术较L_(4-5)节段难度大,但均能取得较好的临床效果。因此,开展PELD应先从相对简单的L_(4-5)椎间盘突出入手,积累到一定经验后再开展L_5-S_1节段。 相似文献
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Michael Kottlors Klaus Mueller Janbernd Kirschner Franz Xaver Glocker 《Joint, bone, spine : revue du rhumatisme》2009,76(5):562-564
We report on a case with hypertrophy of the tibial muscles and to a lesser extent of the calf muscles preceded by a lumbar syndrome and sciatica. Lumbar myelography disclosed a discogenic compression of the L5 nerve root. Muscle biopsy of the peroneal muscles showed a marked type I fibre predominance and hypertrophy but no inflammatory infiltration. We consider the possibility that radiculopathy not only of the S1 nerve root but also of the L5 root can trigger hypertrophy of the musculature and must be taken into account of the differential diagnosis of unilateral focal hypertrophy of the lower leg. 相似文献
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Hidalgo-Ovejero AM García-Mata S Sánchez-Villares JJ Lasanta P Izco-Cabezón T Martínez-Grande M 《American journal of orthopedics (Belle Mead, N.J.)》2003,32(8):392-394
We present the rare case of a patient affected by low back pain and bilateral L5 sciatica from an L2-L3 herniation. Only 2 cases of monoradicular L5 compression in the high lumbar spine have been reported. The initial computed tomography study of the L4-L5 and L5-S1 spaces revealed no significant alterations. Magnetic resonance imaging showed a disc herniation at L2-3. The electrophysiological study confirmed clinical suspicions of L5 root involvement. A bilateral laminotomy with discectomy on both sides of the L2-3 space was performed. Pain disappeared completely after surgery. The patient remains asymptomatic 2 years after the operation. 相似文献
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Intraradicular herniation of a lumbar disc: a case report 总被引:2,自引:0,他引:2
The authors report an unusual case of intraradicular lumbar disc herniation. A large fragment of lumbar disc was found within the sheath of the right S1 nerve root. Surgical treatment results in a satisfactory clinical outcome. The literature on intradural and intraradicular lumbar disc herniation is reviewed. 相似文献