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At least 379 records · Page 21Linked to original sources
PubMed1989

[Sciatica and nerve root anomalies. Apropos of a series of 20 cases].

We present 20 operative cases of lumbar nerve root anomalies, divided into 6 anatomical types: nerve roots with common dural emergence (4 cases), contiguous dural emergence (6 cases), with common dural sheath (4 cases), splited nerve roots (2 cases), anastomosis between roots (3 cases) and plexiform nerve roots (1 case). 14 cases are associated with a discal hernia. 10 cases presented with unilateral but biradicular sciatica. The asymmetry of emergence is the best symptom of the pre-operative radiological evaluation on the CT scan, moreover on the myelography. The management led to an enlargement of the surgical field by hemilaminectomy to recognize the anomaly and make easier the discectomy. In 3 cases, the anomaly was recognized in patients who had been previously operated on. There are only 53% of satisfactory final results. We present a review of the main publications concerning this subject.

Adult↗
PubMed1989

Gluteal abscess causing sciatica in a patient with systemic lupus erythematosus.

Low back pain and sciatica may be caused by pathology remote from disc and lumbosacral vertebral segments. We report on a 59-year-old patient with systemic lupus erythematosis whose history illustrates this point. The patient was evaluated and diagnosed to have a septic arthritis of the wrist and lumbar spinal stenosis, for which she was treated. The patient's failure to respond to therapy led to further evaluation. A massive gluteal abscess was identified and drained, and with appropriate antibiotic therapy, the patient recovered. Patients with lupus have increased likelihood of infection, and their evaluation should include a search to discover unusual locations in cases that are unresponsive to standard and seemingly appropriate therapy.

Abscess↗
PubMed1989

[Sciatica. Neurofibrosarcoma of the thigh].

A 61-year-old patient had complained of sciatica in the left lower limb for three years. The pain was located in the posterior area of the thigh and leg and radiated to the first toe. Examination showed a tumor of the middle part of the thigh. A sciatic nerve tumor was confirmed at operation. Pathological examination revealed a neurofibrosarcoma. The patient died from pulmonary metastasis 17 months later.

Female↗
PubMedDate not supplied

Lumbar spinal canal size of sciatica patients.

Seven measures at the three lowest lumbar interspaces were recorded from conventional radiographs of the lumbar spines of 160 consecutive patients with low back pain and sciatica admitted for myelography and possible surgery. Eighty-eight patients were operated upon for disc herniation, and of the conservatively-treated 72 patients, 18 had a pathologic and 54 a normal myelogram. The results were evaluated after one year using the occupational handicap scales of WHO. Correlations of radiographic measures to stature were moderate and to age small. After adjusting for stature and age, only the male interpedicular distances and the antero-posterior diameter of intervertebral foramen at L3 were greater than those of females. The males with a pathologic myelogram had smaller posterior disc height at L3 and a smaller interarticular distance at L3 and L4 than those with normal myelogram, likewise the midsagittal diameter at L3 and L4 in females. In all patients other measures besides posterior disc height were smaller than those for low back pain patients (p less than 0.001) or for cadavers (p less than 0.001). The only correlation between measures and clinical manifestations was between pedicular length at L3 and limited straight leg raising. Where the disc material had been extruded into the spinal canal, the interpedicular distance was significantly wider. Only anterior disc height at L3 revealed differences between good and poor outcome one year after surgery, as did the interarticular distance at S1 in patients with normal myelogram after conservative treatment.

Adolescent↗
PubMed1986

"Bony sciatica"--the value of thermography, electromyography, and water-soluble myelography.

With an increased interest in sporting activity, particularly among the older population, together with the appreciation of the importance of "bony entrapment" as a cause of sciatica, so the need has arisen to develop a simple, noninvasive, reliable, and reproducible method of determining whether leg pain is of radicular or referred origin. In our experience, liquid crystal thermography has proved unsatisfactory but electromyography appears to be of value in distinguishing root from referred pain in approximately 70 per cent of patients within this group. Our experience with radiculography within this context is also presented and is shown to be currently unsatisfactory.

Athletic Injuries↗
PubMed1985

[A unusual manifestation of multiple sclerosis: sciatica].

The authors recall the possibility of a typical sciatica in multiple sclerosis and describe seven new cases. Their main clinical features are: early onset before any other signs of the disease, hyperalgic, paroxysmal, short, repetitive episodes, absence of mechanical or effort triggers, absence of improvement with rest or anti-inflammatory drugs, well defined course. The intra-medullar origin of these attacks is suggested by the clinical criteria and the aspect of evoked potentials of the lower limbs recorded in 2 of the 7 patients.

Adult↗
PubMed1982

[Therapeutic concept of the flexion corset in a chronic lumbar syndrome and sciatica].

Lumbar flexion and reducing lumbar lordosis or hyperlordosis are basic principles in the treatment of chronic or recurrent low back syndrome, lumbar insufficiency and sciatica. This can be achieved by the Hamburger Flexion Corset, which is built by moduls. The front part of the brace exerts, compression on the abdomen by a deep imprint, so that the lumbar spine will be gradually transformed.

Back Pain↗
PubMed1982

[70 patients operated on for sciatica without herniated disk].

Seventy patients suffering from sciatica were operated in whom no disc herniation was found. In 42 instances, compression of bony origin was found. These cases were either due to general narrowing of the spinal canal with signs in the distribution of several roots with neurological intermittent claudication, or to narrowing of the lateral recess or intervertebral foramen with involvement of only one root. Decompressive surgery was always beneficial for pain. In 20 instances a disc was found to be only bulging; disc excision was performed in 17 of these patients. In 8 instances, no abnormality was found. Some patients were nevertheless cured by disc excision, a single laminectomy being useful. The incidence of additional psychological problems is discussed. It is concluded that the clinical signs should guide the surgeon rather than the radiological findings in decisions for surgical treatment. Patients who have been correctly treated by conservative means for an adequate time should be systematically operated on if they have not shown sufficient clinical improvement.

Adult↗
PubMed1982

[Iliolumbar syndrome. A syndesmoperiostitis of the iliac crest. Clinical, radiologic and therapeutic summary. Diagnosis with lumbar sciatica. 440 cases].

The authors studied the files of 440 patients with low back pain over a period of 8 years. The constant absence of signs of lumbar sciatica led them to study the aetiology of such a pain. Pain in the ilio-lumbar ligament is due to the development of a syndesmo-periostitis (syndesmos = ligament) from the ligamentis continual traction on the postero-medial iliac crest. This is a discrete clinical entity described by the term "ilio-lumbar syndrome".

Back Pain↗
PubMed1984

[Chemonucleolysis in the treatment of sciatica caused by herniated disk].

Chemonucleolysis is an effective treatment of sciatica due to herniated lumbar disc after conservative treatments have failed. Provided the proper technique is applied and the patients are well selected (complete herniation or herniation within a narrow spinal canal being excluded), surgery can be avoided in the majority of cases. Chemonucleolysis does not in any way complicate subsequent surgery if required and post-nucleolysis surgery gives the same results as first intention surgery. The method, therefore, should not be regarded as an alternative to surgery but as the last stage of conservative treatment. Allergic reactions are the only true side-effects and require special precautions.

Anaphylaxis↗
PubMed1982

[History of sciatica].

The long history of sciatica is recalled from the 18th century observations through the contributions of Lasègue (a philosopher who worked with Claude Bernard), Valleix, Brissaud, Dejerine, Sicard, Forestier, Alajouanine and Petit-Dutaillis. Two papers by professor de Sèze on the significance of herniations of lumbar disks were published in December 1939 and June 1940, a most unfavourable period in France. Since then many advances are to be recorded among which the use of metrizamide instead of the old lipiodol and, most of all, the advent of CT Scan.

France↗
PubMed1983

[Acupuncture and sciatica in the acute phase. Double-blind study of 30 cases].

Responses to acupuncture were studied in 30 patients with acute sciatica. Objective and subjective criteria were analyzed before treatment and after five sessions of acupuncture. The study was double blind. Patients were randomly assigned to one of two groups: 15 were treated on electrically detected points and 15 on "placebo" points. In the "placebo" group, no significant improvement was recorded. Conversely, in the treated group, study of objective criteria showed improvement of the Lasegue sign. Among subjective symptoms, positive responses were recorded in the duration of improvement, degree of improvement in decubitus and after ten minutes standing, and use of analgesics. Compared to the "placebo" group these changes are statistically significant.

Acupuncture Therapy↗
PubMed1984

[Respective importance of the intradural contrast examination and of the scanning in operable sciatica].

It is not always possible to determine the numerical predictive values of two different diagnostic tests such as contrast studies with myelography and evaluation by CT scan in the preoperative evaluation of sciatica. The reliability of these predictive calculations can be subject to error. However, the concordant results of most studies favor the CT scan. We have given the predictive values of these tests as mentioned in the literature along with our own series comparing these two methods. Overall, the CT scan is though to be a better diagnostic tool for medio-lateral herniated discs at the L5-S1 level which are not seen using amipaque due to the greater thickness of the epidural space and for lateral herniations at the L4-L5 and L5-S1 levels. Thus, the Ct scan evaluates more completely the anatomy of the lateral recesses. This is particularly helpful when the anatomical findings differ from that of a classical herniated disc, for example in elderly patients. With amipaque, whose diagnostic yield could be improved by a more careful reading of the roentgenograms, its usefulness lies in the ability to evaluate the entire length of the lumbosacral canal down to the conus medullaris, and gives a better view of the course of the nerve roots.

False Negative Reactions↗
PubMed1983

[Lumbar phlebography. Contribution to the diagnosis of lumbo-sciatica of discal origin].

The authors wanted to define the diagnostic value of lumbar phlebography in the investigation of intervertebral disc lesions and to compare these results with those obtained from clinical examination and plain Y-rays. They conducted a retrospective study of 200 cases of patients hospitalised for sciatica who were investigated by lumbar phlebography using selective catheterisation, without any prior neuro-radiological examination. 104 of these cases were operated. The lumbar phlebography was interpretable in 99 p. cent of cases. Severe thrombo-embolic episodes occurred in two cases. In the 104 patients who went to operation, the surgical procedure confirmed the presence of a herniated disc (suspected on phlebography) in 96 p. cent of cases. Topographical agreement between the phlebographic data and the operative findings was observed in 81 p. cent of cases. Phlebography proved to be more reliable at L4-L5 than at L5-S1. In the patients in whom clinical examination and plain X-ray findings provided coherent information as to the site of the herniated disc, phlebography was considered to be of no use. In those patients for whom this examination did not provide coherent information, phlebography proved to be valuable in the topographical diagnosis of the herniated disc.

Adolescent↗
PubMedDate not supplied

[Injection of the sacrolumbar roots: a complementary method of staging sciatica. 18 cases].

The injection of the sacrolumbar roots allows, in the first place, the root to be made opaque in order to determine its morphology and, in the second place and above all, causes the disappearance of the radicular pain after injection of a local anesthetic, which helps the degree of sciatica to be identified. This method, which should be limited to exceptional cases, seems to be useful in patients who have undergone lumbar surgery and for whom the interpretation of contrast x-ray exams poses a particularly delicate problem. It can also be advisable when these exams are not conclusive or when the results do not coincide with the clinical data. Since March, 1974, 18 patients have undergone this exam. In 14 cases the disappearance of the radicular syndrome, after injection of xylocain close to the root, has allowed the root in question to be identified. In 3 cases radicular injection has practically made it possible to rule out an organic lesion. This exam had no side effect and was always tolerated even by two patients allergic to iodine.

Adult↗
PubMed1981

[The value of compute tomography in "sciatica" (author's transl)].

13 cases of therapy-resistant lumboischialgia without herniated disk, caused in 12 cases by a tumour and in 1 case by an abscess, were examined by computed tomography of the lumbar and pelvic region. This method is indicated immediately after insufficient results of conventional X-ray methods (including tomography) and of lumbosacral radiculography. The compute tomography is indispensable also in patients with "sciatica" with a known malignoma. The informations given by computed tomography are essential for the therapy planning.

Adenocarcinoma↗
PubMedDate not supplied

[Sciatica caused by disk herniation in children. Apropos of 4 cases].

The authors report 4 cases of sciatica from disk herniation occurring in children under 16. It happens rarely in this age range, as is shown in the review of the literature performed for this article. The symptomatology is similar to that in adults. The physical signs are much more prominent than the functional signs. An original traumatism, sometimes severe, is often encountered. The standard X-ray examination is of little use in diagnosis, while contrast studies (opaque myelography, phlebography) clearly show the lesions of compression. Surgical treatment is frequent but not compulsory, following the same rules than in the adults. The post-operative results are usually excellent.

Adolescent↗