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[Extensive bony condensation of the vertebrae in intervertebral disc degeneration. (Study of 25 cases)].

The authors report 25 cases of extensive bony condensation of the vertebrae due to degeneration of the intervertebral discs, giving on lateral XRay a dome-shaped or helmet-shaped appearance. 19 cases occurred in women. Two-thirds of the patients were aged between 35 and 55 years, with an average of 45 years. The lesions were lumbar in 21 patients. They affected in 20 cases two adjacent vertebrae. All the clinical, radiological, pathological and discographic findings, together with the course, confirmed the degenerative origin of these bony condensations, the pathogenesis of which is still not perfectly understood.

Adult

Reoperation after lumbar intervertebral disc surgery.

This retrospective study includes 53 patients who underwent reoperation after failure of lumbar disc surgery to relieve pain. All patients had leg pain before reoperation, which was successful in 28% of cases. Most clinical features, such as persistence or mode of recurrence of pain, radicular quality of pain, positive straight-leg raising, and myelographic root sleeve defects, were not helpful in predicting successful and unsuccessful reoperations. However, a significantly larger percentage of women than men had successful reoperations. Patients who had past or pending compensation claims, who had sensory loss involving more than one dermatome, or who failed to have myelographic dural sac indentations resembling those caused by a herniated disc did poorly with reoperation. A very convincing myelographic defect appears to be needed to justify reoperation at a previously unoperated location. Excision of scar alone or dorsal rhizotomy was of no avail in these cases.

Adult

An analysis of lumbar intervertebral disc prolapse.

Clinical findings and operative results of 212 operated cases of disc protrusion are analyzed in this paper. The maximum age incidence is between 21 and 40 years. In our series disc prolapse was most common between the L4-L5 disc space, mostly on the left side, whereas the L5-S1 is more common in white people. Anthropologic differences may account for the discrepancy. A careful search should be made for disc protrusion by flexing the spine and also exploring the intervertebral foramen during surgery.

Adolescent