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At least 109 records · Page 6Linked to original sources
PubMed1994

[Predictors of treatment success after microsurgical operation of lumbar intervertebral disk displacement].

As far as medical decision making is based on weighing up individual risks and chances of a certain patient receiving a certain treatment, some knowledge is required about signs and symptoms which are associated with a certain outcome: they are called risk factors, or predictive factors. In lumbar intervertebral disc surgery, the most frequent undesired effect of the treatment is unsuccessfulness. Reviewing the literature about risk factors for unsuccessfulness, one recognizes a lot of unconfirmed or even contradictory findings. This inconsistency can possibly be attributed to the common use of a very simplified, unidimensional definition of the target variable "success of treatment". That is why we performed a prospective observational trial on 109 patients in whom the success of lumbar intervertebral disc microsurgery was assessed after half a year using six different target variables. The rate of treatment success varied considerably, from 44% (when "return to previous occupation" served as the target variable) to 91% (with regard to "subjective contentedness"). Further target variables were intensity of sciatica, intensity of low back pain, activities of daily living, and postoperative paresis, giving intermediate success rates. We were able to identify some risk factors (for instance, duration of sick leave and of the recent pain episode, preoperative paresis, intensity of psychosomatic complaints), each of them being relevant to some of the target variables, but none of them associated with all of the target variables. We conclude that the multidimensional rating of treatment successes seems to promote risk research in multidimensional diseases.

Absenteeism↗
PubMed2001

[Intervertebral disk displacement and trauma].

It is difficult to find medical evidence of a correlation between a lumbar disk disease and trauma. One should consider whether the individual degeneration of lumbar disks or the trauma lead to the typical complaints. Disk disease in the population are very common. Therefore the relevance of the individual affection before trauma has to be considered. Spinal trauma with its sudden, incidental onset needs to be differentiated from purposeful and conscious movements. An intervertebral disk disease can be classified as accident related only in cases involving adequate trauma, with no previous complains, and a sudden onset of pain.

Diagnosis, Differential↗
PubMed1983

[Diagnosis and therapy of lateral intervertebral disk displacements. I. Normal roentgen anatomy of the lumbar nerve roots in computer tomography].

As a basis for the CT diagnosis of lateral disc herniations, the normal anatomy of the nerve roots from L4 to S1 within the lateral recess, is described and compared with the myelographic and CT findings. In myelograms, the roots can be demonstrated from where they leave the dural sac, for about the height of one vertebral body as far as the spinal ganglion in the upper part of the intervertebral foramen, where the subarachnoid space terminates. By non-enhanced CT, the roots can be distinguished from the surrounding fat only in the widening lower part of the lateral recess. The ganglion and the spinal nerve can be shown in the intervertebral foramen and further distally where they can no longer be seen on the myelogram,. Thus, of both these complementary techniques, CT s more suitable for the diagnosis of lateral disc herniations.

Humans↗
PubMedDate not supplied

[Stenosis of the lumbar canal and intervertebral disk displacement in the aged].

The acquired narrow lumbar canal with compression of epidural cavity and nerve root canals is caused by degenerative bony changes and disc herniation. Clinical and radiological findings are described, especially those in myelography and computerized tomography. Complaints, resistant to conservative treatment, with neurological deficits accompanied by sciatica or intermittent claudication requires a surgical intervention even in old patients. The operative procedure includes decompression of myelin and nerve roots by hemilaminectomy or even laminectomy on one or more levels, combined with partial resection of hypertrophic facets of the intervertebral joints and, if necessary, with nucleotomy. Even old patients can successfully be treated by surgical decompression without severe intra- and postoperative complications, if a good perioperative care and an early postoperative mobilisation are guaranteed. The results with regression of the neurological deficits and with good subjective evaluation are demonstrated by the clinical follow-up of 33 patients aged more than 70 years.

Aged↗
PubMed1989

[Etiology of the recurrence of lumbar intervertebral disk displacement].

In a review for reasons of 100 disc prolapses reoperations we found in 62% a recurrence of disc prolapse at the same level, in 24% a recurrence at a different level, whereas in 14% we found that the nerve route was closely connected. We reoperated 44% in the first two years and 69% in the first five years. The time between the operations was prolonged if there was a short period of time for relief of pain after operation and a long period of preoperative symptoms. The variables of risk of a disk prolapse recurrence are recorded in a risk score, in which 64% of the patients belonged retrospectively to a risk group. The correlation between operation interval and score points showed that patients with short interval had high score ratings.

Adult↗
PubMedDate not supplied

[Effect of meteorologic parameters on acute admission of patients with lumbar intervertebral disk displacement].

The correlation between local meteorological parameters and acute admittance to hospital of patients with lumbar disk prolapses was investigated. The study shows a significant correlation between drop of temperature and increase of humidity for male on the day of admittance and for female on changes from the day before to the day of admittance. This seems to be in contrast with other investigators, who couldn't find a correlation between local meteorological parameters and pain. The reasons for this are discussed.

Acute Disease↗
PubMed1989

[Clinico-neurologic long-term results following surgery of intervertebral disk displacement].

Of the 1732 patients undergoing disk surgery in the period 1971-1980, a sample of 245 was selected, and data gathered prior to their operations compared with data gathered two to twelve years after the operation. Analyses was made of the specific character of pain, the state of the reflexes, motor and sensory failure, Lasègue's sign, finger-ground-distance Disorders of bladder and Rectum, and the patients' subjective judgement of their complaints. The possibility of improvement in the various findings is discussed.

Adult↗
PubMed1996

[Intraoperative ultrasound in lumbar intervertebral disk displacement].

UNLABELLED: Intraoperative ultrasound of the spine has been used in neurosurgery (tumours) and traumatology (reposition of fractured vertebral bodies fragments). AIM: To describe initial experiences with this method and to document the opportunities and problems. METHOD: 24 nucleotomies were documented and evaluated. Sonography was performed using a 7.5 MHz sector probe and a typical surgical approach. RESULTS: In 21 of 24 cases, imaging of intraspinal structures was possible. The complete extraction of the herniated disk could be documented. In 3 cases the examination failed because the probe was too large to be pushed down between the spinous processes and the wound retractor to the operative site. CONCLUSIONS: Intraoperative sonography can be used easily as a routine method for exploration of the spinal canal. Technical innovations in the probes would make the method even more feasible.

Adult↗
PubMed1991

[Unilateral paralysis of the abdominal wall musculature caused by thoracic intervertebral disk displacement].

Herniated thoracic discs are rare. Many cases present with local radicular or cord symptoms. We describe a case which became symptomatic by a unilateral paresis of the muscles of the abdominal wall. This radicular syndrome has only been described for lumbar disc herniations before. The differential diagnosis is discussed as well as the importance of myelography and the value of Myelo-CT.

Abdominal Muscles↗
PubMed1997

[Endoscopic treatment of intervertebral disk displacement. Percutaneous transforaminal access to the epidural space. Indications, technique and initial results].

The authors report their experiences with the percutaneous transforaminal approach to the epidural space. 85 patients were treated endoscopically for non-contained lumbar herniated discs. Very good and good results of 20 patients (learning curve) were obtained in 65%. However, reoperation rate was 25% versus 3% for the last 65 patients. The first 50 patients were treated under local anaesthesia, the last 35 patients under general anaesthesia. Operative technique is described in detail. Laser application in the epidural space is helpful for tissue ablation and to obtain hemostasis. No complications were observed. The main advantages of this new minimal invasive technique are, besides reduced morbidity, less epidural scarring and removal of the sequestered tissue under visual control while retaining disc tissue in the intervertebral space. Thus, the disadvantages of open nucleotomy with possible instability and abundant scarring may be avoided.

Adult↗
PubMed1989

[Lumbar intervertebral disk disease and its sequelae: segmental instability, intervertebral disk displacement, lumbar spinal stenosis--change in a common disease].

Clinical, radiological, surgical and experimental experiences allow to construct a theory of degeneration of the lumbar spine, which explains the pathogenesis of spondylosis, stenosis and disc displacement as well. The centre of the whole process is the segmental instability due to disc derangement. Several partially new criteria for a rational surgical and conservative therapy follow from such theory, which we try to explain by some exemplaric cases. Finally, we describe shortly own surgical procedure for combined operation of decompression and lumbar fusion.

Follow-Up Studies↗
PubMed1992

[Neuroradiologic treatment possibilities of intervertebral disk displacement].

A CT assisted method for automated percutaneous lumbar discectomy (APLD) is described. With this technique and introduction of a "pull and push" method as well extruded and sequestrated herniated lumbar discs as cervical herniated discs can be treated. The CT assisted discectomy was performed in 70 patients. The success rate was 86% in the lumbar region and 93% for cervical herniated discs. We believe that this percutaneous technique will increase the importance of interventional neuroradiology for this common disease.

Adult↗
PubMed1992

[The prognosis of conservatively treated lumbar intervertebral disk displacement].

72 out of 120 patients who where treated conservatively for proven lumbar disc prolapse over a seven-year-period were reexamined. Questionnaires could be obtained and evaluated for 91 patients. The date of reexamination was an average of 44.5 months after the end of inpatient-treatment. Results are given for the duration of inability to work and the "return to work" (RTW)-rate. The ability to work of 54 patients was regained after an average of 11.1 weeks, 95% of patients could return to their previous workplace.

Female↗
PubMedDate not supplied

[Clinical aspects, surgical treatment and prognosis of lumbar intervertebral disk displacement in childhood].

This paper reports on 11 girls and 3 boys aged from 12 to 16 who, having suffered prolapses of lumbar discs, underwent surgery and were followed up between 18 and 87 months postoperatively. These 14 patients represent 0.25% of those who have undergone disc surgery in the authors' clinic over the last 11 years. Clinical peculiarities are pointed out and, in the light of the positive results (13 patients completely free of complaints) the prognosis is deemed to be very favourable; surgical treatment is therefore recommended of conservative therapy fails.

Adolescent↗
PubMed1993

[Lumbar and cervical "traumatic intervertebral disk displacement"].

25 cases with traumatic lumbar and cervical disc herniation are described and criteria for a causal connection between trauma and prolapse are discussed: 1. The accident must be adequate, e.g. jumps from considerable height, falls, car collisions and lifting heavy weights (only in private insurance companies). 2. Typical discopathic complaints must occur soon after the accident. 3. Major degenerative disease before trauma of the vertebral column must be excluded. The medical expert has to assess in each case of possible traumatic disc herniation the cause of trauma and the resulting reduction of earning capacity.

Adult↗
PubMed1987

[Spinal ultrasound tomography in the diagnosis of lumbar intervertebral disk displacement].

By comparative sonographic and myelographic investigations of 61 patients with lumbar disc herniations and other nerval compressive syndromes, the value of the spinal sonography in the diagnosis of lumbar disc herniation is demonstrated. The transversal transabdominal representation of lumbar disc herniations is successful in 82% of all cases. The sensitivity of sonography amounts to 0.73 in the segment L5/S1 and to 0.92 in the segment L4/5. In connection with the neurological investigation and X-ray films of the lumbar spine, the spinal sonography as a noninvasive procedure can represent an useful alternative to the myelographic diagnosis of the lumbar disc herniation.

Adolescent↗