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PubMedDate not supplied

[Diurnal rhythm of pain in sciatica. Preliminary report].

Similarly as nearly all processes taking place continuously in the organism pain shows also frequently a circadian rhythm. In 30 patients with ischalgia pain intensity was studied over 24-hour periods during 7 successive days. The patients noted graphically the intensity of pain on a specially prepared scale. In the light of the data obtained from the patients three types of circadian pain rhythm curves were isolated. In 83,3% of cases the co urse of pain had an evident circadian rhythm returning during successive days. In 19 cases (63.3%) pain was particularly increased in the evening and night hours. In 6 cases (20%) the peak intensity of pain was in the morning hours (5-10 a.m.). In the remaining 5 cases (16%) its intensity was unchanged, without any circadian fluctuations. No relationship was demonstrated between pain rhythm and the age, sex, disease duration, spinal radiological changes, sensory or motor deficit. Pain rhythm is individual feature connected, probably, with other rhythmic processes in the organism, particularly with the rhythm of corticosteroid or endorphin release. Increased intensity of pain may be connected with falling level of these substances in the organism. In 35 patients with a significant nocturnal rhythm of ischalgic pain a trial was undertaken of treating the pain with dexomethasone administered in the evening hours in the painless period. The doses were 1-2 mg. In nearly 70% of cases (24 patients) a good effect of this treatment was obtained. This work based exclusively on clinical observations requires further studies and it is regarded by the authors as a preliminary communication.

Adult↗
PubMed1981

[Recurrence of sciatica in patients operated on for disk hernia: postoperative segmental spondylosis].

Forty four patients, admitted to the department of of Neurosurgery of the Hospital of Parma, for a recurrence of sciatic pain following discectomy, have been examined between May 1978 and February 1981. In 30 patients myelography was negative for discal hernias, while plain x-ray films and polytomograms of the lumbar spine showed lateral recesses and intervertebral foramina stenosis with roots' compression. The surgical procedures were: medial facetectomy, total facetectomy or hemilaminectomy with removal of pedicle and inferior and superior articular processes, according to the case, obtaining the remission of the pain. We feel that we are dealing with an entrapment syndrome of one or more lumbosacral roots secondary to degenerative spondylotic changes of the lamina-pedicle-facet complex that follows discectomy and is specially located in the same space previously operated upon. We are describing the pathological, clinical and radiological features of this syndrome and the surgical technique used.

Adult↗
PubMedDate not supplied

[Clinico-etiological correlations in children with sciatica].

During a period of 30 years 21 children with sciatic pains were treated at the Developmental Age Neurology, Medical Academy in Gdańsk. The aetiological factors and clinical manifestations were analysed. Nucleus pulposus prolapse was diagnosed in 5 children, in 9 cases neoplasms were found (in 3 cases malignant tumours of the sacral bone, intraspinal tumours in 6 cases); in 4 cases obliterative intraspinal arachnitis, and in 3 cases other causes were diagnosed. With the exception of one child the other ones were in the school-age group. In nearly all cases the onset was insidious. In one-third of children with neoplastic processes the neurological symptoms appeared after injuries and caused initially considerable diagnostic difficulties. In 18 cases disturbances of spinal configuration and mobility were observed. Pain produced by stretching was present in 20 cases. Sphincter disturbances were observed in 6 cases (including 5 with tumours). Motor defects were noticed in all patients, more pronounced in cases of tumours. Patency of the subarachnoid spinal space was without any greater importance for the diagnosis of sciatic pains. Raised protein level in the cerebrospinal fluid was highest in cases of intraspinal tumours, and it was moderately pronounced in obliterative arachnitis, while in nucleus pulposus prolapse the protein level varied. Plain films were of lower diagnostic importance, with the exception of sacral bone tumours and nucleus pulposus prolapse. Of greater importance were contrast medium radiological examinations of fluid spaces.

Adolescent↗
PubMed1983

[Microsurgery of common discal sciatica. Technics and results].

The authors report their own experience of microsurgery for surgical treatment of lumbar disc herniation. Series include 30 cases with a one year of mean follow up. Comparative studies are discussed according to others microsurgical series already published. Good care of peridural fat and gently retraction of the root seem to be main factors for good functional result.

Follow-Up Studies↗