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At least 253 records · Page 14Linked to original sources

PubMed1983

[An unusual cause of sciatica: soft tissue desmoid tumor. Apropos of 2 cases].

The authors report 2 cases of sciatica resulting from nervous compression by a desmoid tumour in women aged 33 and 27 years. In each case, careful exeresis did not prevent recurrence as shown by tomodensitometry. Eight other well-documented cases were found in the literature. The desmoid tumour penetrates the buttock and thigh muscles and presses the sciatic nerve. The patients often suffer from previous and persistent sciatica which can combine with hip restriction. The responsible tumour made up of abundant bundles of collagenous fibers, a small number of fusiform cells without mitosis or atypics and on the periphery degenerative and dissociated muscle fibers is usually discovered late. Tomodensitometry is the best means of detection, evaluation of the extent, adhesions and recurrence during the observation period. Treatment is usually surgical and success depends on the quality of the exeresis. Other methods, corticoid, anti-oestrogen and radiotherapy, sometimes effective in desmoid tumours of the abdominal wall, do not prevent recurrence in the buttocks or thighs which are of sciatic derivation.

Adult↗

PubMed1981

Sciatica in CGL: a sign of transformation.

Six patients are presented with chronic granulocytic leukaemia in whom sciatica and back pain developed. Within a few months of the onset of the symptoms other manifestations of acceleration of the disease became manifest and all patients subsequently died. Radiological evidence of bony infiltration was noted in two patients and post-mortem evidence of infiltration in a further two patients and it is suggested that the development of sciatica may herald the terminal stage of the disease.

Adult↗

PubMed1982

[Chemonucleolysis in the treatment of sciatica from herniated lumbar disc (author's transl)].

A proteolytic enzyme was used to dissolve the nucleus pulposus in 140 cases of sciatica from herniated lumbar disc. The results were satisfactory in 75% of 120 patients followed up for more than 6 months. This percentage of success, similar to that obtained with surgical excision of the disc, can only be achieved with a rigourous technique and, more importantly, with strict selection of the patients. Chemonucleolysis is indicated only for patients with unquestionable clinical and radiological evidence of herniated disc, in which case it can be considered as the ultimate medical treatment of sciatica associated with this lesion. No serious complications were observed in our series, but the risk of allergic reaction must be borne in mind.

Adolescent↗

PubMed1994

[Atypical sciatica. Decreasing pain and increasing paresis--a serious sign].

During the last seven years 14 patients with lumbar disc hernias were admitted who presented with a short period of sciatica before experiencing relief of pain accompanied by paresis. Ten patients had marked paresis and were operated on, most of them during the first week after the start of paresis. Three patients had minor paresis in regression, and one patient suffered complete paralysis for five months. These four patients were not operated on. Motor function improved significantly in nine out of ten operated patients. Four of them had no paresis at all. The three patients with mild paresis in regression still showed some motor impairment 9-24 months later, and the condition of the patient with paralysis remained unchanged. In conclusion, patients who develop painless sciatica and marked paresis deteriorate seriously, and early surgery is necessary in order to avoid permanent disturbance of motor function.

Adult↗

PubMed1998

[Sciatica--diagnosis and surgical management].

Sciatica (a term used synonymously with lumbar radiculopathy) is usually caused by lumbar disc herniation or lumbar spinal stenosis. Mechanical compression of nerve roots is a predominant factor, and decompression the surgical goal. Emphasis should be placed on clinical identification of the nerve roots causing the complaint. Although computed tomography (CT) and magnetic resonance imaging (MRI) are the most important diagnostic tools used today, plain x-ray may be required for correct identification of the lowest mobile segment, and the functional myelography combined with CT may be required if lumbar spinal stenosis is suspected, or if the clinical findings are unclear--especially if the patient has already undergone surgery for sciatica. The proper selection for candidates for surgery seems to be a more important determinant of successful outcome than whether macro- or micro-surgery is used, or whether one or more segments are operated upon (12, 13). Clear clinical identification of the roots affected and corresponding pathological findings at imaging are the best predictors of successful surgical outcome, an additional factor of positive predictive value being psychosocial stability. Impaired fibrinolysis, occurring in smokers and in the sedentary and obese, may be a negative predictive factor (10, 11). Published findings suggest that, unlike the case with disc surgery (9), neither long duration of symptoms nor long preoperative sick leave is associated with poor outcome of surgery for spinal stenosis (14).

Female↗

PubMed1998

[Tomodensitometric image of the lumbar spine. Study of 150 patients hospitalized for discal sciatica].

OBJECTIVES: There would be some discordance between patient expectations and expert recommendations concerning computed tomography (CT) of the spine for discal disorders. We analyzed patient opinion. PATIENTS AND METHODS: At admission, a 25-item questionnaire was given to 150 patients hospitalized in a rheumatology unit for discal sciatica. Patients were asked to express their expectations concerning the CT exploration. RESULTS: Seventy percent of the patients had already undergone CT explorations requested by a general practitioner (55%) or a specialist (45%), 20% had had two CT explorations and 20% magnetic resonance imaging. Seventy-five percent felt they should have had a CT scan earlier, 85% thought a CT should be performed for back pain of less than one month duration and 96% in case of sciatica for 2 months or more. Patients felt their exploration came "late" because the physician was under financial pressure (52%), had incorrectly appreciated the patient's need (28%) or was incompetent in the matter (22%). Nevertheless, 15% of the patients recognized that the CT scan could be useless and 89% knew that all cases of hernia are not operable. Thirty percent recognized that hernias can go undetected on the CT scan and 78% that they may remain asymptomatic. Finally, 56% of the patients thought that the CT scan would not change their treatment and only 23% expected to undergo surgery sooner because of the CT exploration. DISCUSSION: Several factors would explain what patients expect from CT exploration of the spine: patient understanding that causes other than discal hernia can cause back pain (98%) or sciatic (77%); their fear of having another disorder (56% wanted to be reassured, which would explain in part why 27% hoped the CT would improve pain, 50% wanted to "see" their discal hernia, and 30 wanted to eliminate another cause of their pain); patient distrust of clinical diagnosis which they felt was less pertinent than CT (80% of the patients for generalists and 70% for specialists). Patient expectations did not appear to be limited by fear of irradiation (unrecognized by 90% of the patients) nor the cost of the exploration which was overestimated by 70% of them.

Aged↗

PubMed1998

[New information concerning pain caused by herniated disk and sciatica. Exposure to disk tissue sensitizes the nerve roots].

Sciatica has long been considered to be solely due to mechanical deformation (compression) of a spinal nerve root by herniating disc tissue. However, recent experimental findings have demonstrated that, even in the absence of mechanical insult, nucleus pulposus-related substances may not only induce significant structural and functional injury to the adjacent nerve root, but also sensitise the nerve root, producing pain in the event of subsequent root compression. Although neither the specific mechanisms nor the active nucleus pulposus-related substances causing pain have yet been identified, the recent findings suggest that the future may well bring new pharmacological treatment alternatives for sciatica and disc herniation.

Animals↗

PubMed1982

Recurrent herpes simplex sciatica and its treatment with amantadine hydrochloride.

Seven patients with recurrent herpes simplex and sciatic neuralgia are presented. All were premenopausal women, and six had premenstrual onset. Amantadine hydrochloride taken at the first sign and symptoms of herpes simplex vesiculation prevented or aborted neuralgia in the six patients given this medication. Recognition of the herpes simplex sciatica syndrome is important because the signs and symptoms associated with this condition may lead to unnecessary myelography. Herpes simplex radiculitis, including herpes simplex sciatica, may occur more frequently than recognized.

Adult↗

PubMed1976

Division of the pyriformis muscle for the treatment of sciatica. Postlaminectomy syndrome and osteoarthritis of the spine.

Division of the pyriformis muscle at its tendinous insertion was employed for the treatment of sciatica in 14 patients with postlaminectomy syndrome and osteoarthritis of the spine. Of these patients, 85% had satisfactory results. It is logical that the pyriformis muscle can play an important role in the production of sciatic associated with intraspinal lesions. Tension on the sciatic nerve, which passes in close approximation to the pyriformis muscle anteriorly, can be relieved by division of the pyriformis muscle.

Adult↗

PubMed1995

Isthmic lumbar spondylolisthesis with sciatica: the role of the disc.

Thirty-one patients with isthmic spondylolisthesis were investigated using MR imaging. Twenty-one of these patients had selectively unilateral sciatica and no abnormalities on adjacent discs. In 18 patients there was a clear correlation between the degree of foraminal stenosis and the symptomatic side. In 20 patients there was evidence of root compression by disc tissue.

Adult↗

PubMed1988

Dimensions of the spinal canal in individuals symptomatic and non-symptomatic for sciatica: a CT study.

Measurements obtained in 50 spinal CT studies of patients referred for suspected lumbo-sacral nerve root compression, were compared to those of a group of 30 individuals asymptomatic in this respect, who had been referred for abdominal pathology. Transverse ligamentous interfacet and transverse dural dimensions were significantly reduced in the sciatica group, with usually normal interpedicular and sagittal dimensions ruling out idiopathic developmental stenosis. The borderline value for ligamentous interfacet distance (ILD) at L4-5 appeared to be 11 mm.

Humans↗

PubMed1996

Spinal epidural abscess: an unusual cause of sciatica.

A previously healthy patient was admitted to our hospital because of low back pain and sciatica. For 4 weeks preceding the admission, he had been treated with nonsteroidal antiinflammatory analgetics and bed rest with a clinical diagnosis of lumbar disc herniation. On admission, the patient was subfebrile but developed general symptoms of septic infection by the next day. Computed tomography and magnetic resonance imaging of the lumbar spine revealed a spinal epidural abscess and spondylodiscitis at the L5-S1 level. During an emergency laminotomy, gross pus in abundance was evacuated from the epidural space; microbiological cultures from the pus and blood yielded Staphylococcus aureus. The unique clinical presentation of our patient combined with merely indolent symptoms of infection delayed the correct diagnosis. We are not aware of any similar reports of patients with lower spinal epidural abscess whose primary presentation was sciatic pain.

Abscess↗

PubMed1996

Lumbar spinal surgery for sciatica due to intervertebral disc disease in the elderly.

This report reviews 36 patients aged 71 to 93 years who had lumbar spinal surgery for sciatica pain some with motor and or sensory disturbances and with no motor and sensory disturbances. Even though we found soft disc herniations, these patients should have a thorough circumferential decompression because of bony osteophytes and facet hypertrophy. Special attention is drawn to the removal of herniated discs associated with massive spondylotic degenerative changes.

Aged↗

PubMed1994

Spinal tumour due to primary hyperparathyroidism causing sciatica: case report.

We report a unilateral intraspinal cyst-like lesion adjacent to the lamina and facet joint at the L4-L5 level producing sciatica. Histological examination revealed multinucleate giant cells suggesting a brown tumour. Further studies disclosed primary hyperparathyroidism, whose first manifestation was the lumbar nerve root compression. Previous cases of compression of neural structures by spinal brown tumours are reviewed and a radiological differential diagnosis is presented.

Bone Neoplasms↗

PubMed1977

[Classical low back pain and sciatica syndrome caused by a melanotic nerv sheath tumour of the first sacral root (author's transl)].

This is the description of the case of a 22 year old patient with low back pain and sciatica on the right side investigated by lumbar Dimer-X-Myelography. The result of the examination was an impression in the contrast column at the L5/S 1 level on the right. At operation an intradural tumour, plum-sized, well-defined, and blue-black in colour, was found and removed. Histologically the tumour was melanotic and of high cellular density, with spindle-shaped cells as well as giant cells, with round nuclei, considerable polymorphism, and atypical mitoses. On the basis of the operation finding, the clinical course, and the histology, the diagnosis is melanotic nerve sheath tumour of the first sacral root. For two years following operation the patient has experienced no discomfort.

Adult↗

PubMed1981

Symptomatic herpes zoster and sciatica. A case report.

The author reports a case of a 44-year-old woman with sciatica due to a herniated lumbar disc complicated by the appearance of a zoster eruption over the same, or nearly the same, dermatome. Among the causative factors that trigger herpes zoster prolapsed intervertebral disc is not usually included.

Adult↗

PubMed1996

A critical assessment of clinical diagnosis of disc herniation in patients with monoradicular sciatica.

The diagnostic power or clinical parameters in the diagnosis of lumbar disc herniation in patients with monoradicular pain was evaluated in a prospective study with a 100% verification of the diagnosis. Eighty patients with monoradicular pain corresponding to the fifth lumbar or the first sacral nerve root were included. Pre-operatively a number of clinical parameters were recorded and compared to the intra-operative finding of a disc herniation. The parameters were analysed by receiver operating characteristic (ROC) curves. Results from the available literature were analysed by ROC curves for comparison. In 76% of the cases a disc herniation was discovered. The level of the disc herniation was correctly predicted in 93% of these cases by the location of the pain alone or supplemented by neurological signs. Apart from radicularly distributed pain, all parameters in the present study and in the literature had no or low diagnostic accuracy. Thus, in patients with monoradicular sciatica further clinical parameters do not add to the diagnosis of lumbar disc herniation.

Adolescent↗

PubMed1985

Lancinating pain in post-laminectomy chronic sciatica.

Lancinating pain, as described in tabes dorsalis, was noted in four patients with chronic sciatica after several months of laminectomy. The pain responded well to carbamezapine therapy. Abnormal or ephaptic neural transmission of impulses in the roots was considered to be the cause of such pain.

Carbamazepine↗