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1

Herniated Cervical Disc  

MedlinePLUS

... outer layer can also tear. This can allow displacement of the disc's center (called a herniated or ... diagnosed? A thorough clinical evaluation to determine the character and location of the pain plus an examination ...

2

Herniated lumbar disc  

PubMed Central

Introduction Herniated lumbar disc is a displacement of disc material (nucleus pulposus or annulus fibrosis) beyond the intervertebral disc space. The highest prevalence is among people aged 30-50 years, with a male to female ratio of 2:1. There is little evidence to suggest that drug treatments are effective in treating herniated disc. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of drug treatments, non-drug treatments, and surgery for herniated lumbar disc? We searched: Medline, Embase, The Cochrane Library, and other important databases up to July 2008 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 49 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions In this systematic review, we present information relating to the effectiveness and safety of the following interventions: acupuncture, advice to stay active, analgesics, antidepressants, bed rest, corticosteroids (epidural injections), cytokine inhibitors (infliximab), discectomy (automated percutaneous, laser, microdisectomy, standard), exercise therapy, heat, ice, massage, muscle relaxants, non-steroidal anti-inflammatory drugs (NSAIDs), percutaneous disc decompression, spinal manipulation, and traction.

2009-01-01

3

Ochronosis and lumbar disc herniation  

Microsoft Academic Search

Summary  Alkaptonuria is a rare, autosomal recessive metabolic disorder in which the homogentisic acid oxidase activity is absent.\\u000a Its incidence is as low as 0.001%. Ochronosis is the pigmentation of connective tissues and this pigmentation leads to degenerative\\u000a changes in alkaptonuric patients.\\u000a \\u000a Alkaptonuria most prominently involves the lumbar region, but lumbar disc herniation as the presenting feature of alkaptonuria\\u000a is not

D. Gürkanlar; M. Daneyemez; I. Solmaz; C. Temiz

2006-01-01

4

Endoscopic Discectomy for Extraforaminal Lumbar Disc Herniation  

Microsoft Academic Search

The microendoscopic discectomy (MED) technique has been one of the promising surgeries for lumbar disc herniation in the last few years. The purpose of this study is to report the feasibility of a minimally invasive technique for extraforaminal lumbar disc herniation. Ten patients with extraforaminal lumbar disc herniation (one at L3-4, four at L4-5, and five at L5-S1) underwent MED

Yuichi Takano; Nobuhiro Yuasa

5

Two-Level Thoracic Disc Herniation  

Microsoft Academic Search

We report a rare case of two-level thoracic disc herniation that occurred in a 48-year-old woman. She was referred with a 10-month history of pain on the right side of the thorax. On examination, she had hypoesthesia and hypalgesia in the right T6-T8 dermatomes. An MRI scan revealed a large herniated disc at the T7\\/8 level and a smaller herniated

NIELS LEVI; KJELD DONS

6

[Dorsal disc herniation. 13 cases].  

PubMed

Thirteen patients with thoracic disc herniation have been operated on between 1960 and 1984. Nine presented with a progressive cord compression syndrome affecting sensory function more than motor. Four patients presented with acute cord compression. During this period, the authors have abandoned medullary angiography and myelography. The diagnosis is now based on computerised myelotomography. Three cases were treated by laminectomy with two postoperative deteriorations. Two cases were treated by a transthoracic approach which seemed to be too risky. Eight cases were treated through a postero-lateral approach, six being through a transverse arthropediculectomy using a microscope for better dissection of the vessels and Harrington rods to avoid secondary kyphosis. Seven of 9 cord syndromes were improved. Four cases with predominantly radicular syndromes were all improved. PMID:3797727

Lesoin, F; Rousseaux, M; Autricque, A; Villette, L; Clarisse, J; Jomin, M

1986-01-01

7

Revision surgery for lumbar disc herniation  

Microsoft Academic Search

We reviewed 45 patients who had undergone repeated open operations for lumbar disc herniation. There were 26 men and 19 women with a mean follow up of 4.3 years. Twenty-four patients had had one previous discectomy, 12 had 2, and 9 had 3 or more; 11 needed a fusion without instrumentation. Residual or re-extruded disc hernias, either sub- or transligamentous,

H. Baba; Q. Chen; K. Kamitani; S. Imura; K. Tomita

1995-01-01

8

Percutaneous treatment of intervertebral disc herniation.  

PubMed

Interventional radiology plays a major role in the management of symptomatic intervertebral disc herniations. In the absence of significant pain relief with conservative treatment including oral pain killers and anti-inflammatory drugs, selective image-guided periradicular infiltrations are generally indicated. The precise control of needle positioning allows optimal distribution of steroids along the painful nerve root. After 6 weeks of failure of conservative treatment including periradicular infiltration, treatment aiming to decompress or remove the herniation is considered. Conventional open surgery offers suboptimal results and is associated with significant morbidity. To achieve minimally invasive discal decompression, different percutaneous techniques have been developed. Their principle is to remove a small volume of nucleus, which results in an important reduction of intradiscal pressure and subsequently reduction of pressure inside the disc herniation. However, only contained disc herniations determined by computed tomography or magnetic resonance are indicated for these techniques. Thermal techniques such as radiofrequency or laser nucleotomy seem to be more effective than purely mechanical nucleotomy; indeed, they achieve discal decompression but also thermal destruction of intradiscal nociceptors, which may play a major role in the physiopathology of discal pain. The techniques of image-guided spinal periradicular infiltration and percutaneous nucleotomy with laser and radiofrequency are presented with emphasis on their best indications. PMID:21629404

Buy, Xavier; Gangi, Afshin

2010-06-01

9

Disc degeneration after disc herniation: are we accelerating the process?  

PubMed Central

Study design:?Systematic review. Study rationale:?Disc degeneration is a common process starting early in life. Often disc herniation is an early step in disc degeneration, which may cause pain or stenosis. How quickly this subsequent disc degeneration occurs following a disc herniation and subsequent surgical treatment and whether certain spinal procedures increase the rate of degeneration remain unclear. Objectives:?To investigate the risk of subsequent radiographic disc degeneration following discectomy, discography, and conservative care in patients with a first-time diagnosed herniated nucleus pulpous (HNP) and to ascertain whether this risk in these defined groups changes over time. Methods:?A systematic review of pertinent articles published up to June 2012. Key articles were searched to identify studies evaluating the risk of subsequent radiographic disc degeneration following treatment for HNP. Studies that included patients undergoing secondary surgery for disc herniation or that did not use a validated classification system to measure the severity of disc degeneration were excluded. Two independent reviewers assessed the strength of evidence using the GRADE criteria and disagreements were resolved by consensus. Results:?From a total of 147 possible citations, three cohort studies (class of evidence III) met our inclusion criteria and form the basis for this report. The risk of subsequent lumbar disc degeneration following standard discectomy was significantly greater compared with both microdiscectomy (48.7% vs 9.1%) and asymptomatic controls (90% vs 68%) in two studies with mean follow-ups of 5.5 and 25.3 years, respectively. Following conservative care for first-time HNP in the third study, the risk of progression of lumbar disc degeneration was 47.6% over the first 2 years of follow-up and 95.2% over the next 6 years of follow-up. In the same study, the risk of lumbar disc degeneration was shown to increase incrementally over the course of the 8-year follow-up, with all patients showing signs of degeneration at final examination. Conclusion:?Standard discectomy in first-time lumbar HNP may increase the risk of subsequent same-level lumbar disc degeneration compared with microdiscectomy as seen in one low-quality study. However, disc degeneration is likely a natural, temporal consequence following HNP, as demonstrated in a second low-quality study. The overall strength of evidence for the conclusions is very low.

Schroeder, Josh E.; Dettori, Joseph R.; Brodt, Erika D.; Kaplan, Leon

2012-01-01

10

Thoracic disc herniation and spinal cord injury.  

PubMed

A 52-yr-old male developed progressive thoracic myelopathy after a fall. At laminectomy using the standard posterior approach, he was found to have a herniated thoracic disc compressing the spinal cord. Postoperatively, he was paraplegic. We had a series of three such patients. This paper discusses the problems associated with discectomy using the standard posterior approach and reviews the literature about the alternative approaches for surgical treatment available today. PMID:3179014

Hegde, S; Staas, W E

1988-10-01

11

Resorption of thoracic disc herniation. Report of 2 cases.  

PubMed

The authors describe 2 cases of thoracic disc herniation, resulting in acute myelopathy without bladder dysfunction or progressive muscular weakness; the herniated disc apparently resorbed without surgical intervention. Thoracic disc herniations are less frequent than cervical or lumbar disc herniations and are usually associated with severe neurological deficits. In these 2 cases, the herniated discs exhibited marked decreases in size, corresponding to a favorable clinical outcome within a few months after the initiation of conservative treatment with prostaglandin E(1) and/or steroids in conjunction with physical therapy. The authors conclude that thoracic herniated discs are capable of undergoing natural resorption and that conservative treatment could be indicated, even in the presence of moderate myelopathy, when the myelopathy is not accompanied by bladder dysfunction or progressive muscular weakness. PMID:18312085

Haro, Hirotaka; Domoto, Toru; Maekawa, Shingo; Horiuchi, Tadahiro; Komori, Hiromichi; Hamada, Yoshiki

2008-03-01

12

Clinical and Radiological Findings of Nerve Root Herniation after Discectomy of Lumbar Disc Herniation  

PubMed Central

The authors report 2 cases of nerve root herniation after discectomy of a large lumbar disc herniation caused by an unrecognized dural tear. Patients complained of the abrupt onset of radiating pain after lumbar discectomy. Magnetic resonance imaging showed cerebrospinal fluid signal in the disc space and nerve root displacement into the disc space. Symptoms improved after the herniated nerve root was repositioned. Clinical symptoms and suggestive radiologic image findings are important for early diagnosis and treatment.

Bae, Jun Seok; Pee, Yong Hun; Lee, Sang-Ho

2012-01-01

13

Diagnosis and prognosis in lumbar disc herniation.  

PubMed

In a prospective 2-year followup study of 160 consecutive patients undergoing primary surgery for suspected lumbar disc herniation, the authors studied the diagnostic and prognostic factors by using stepwise logistic regression analysis. When the different factors were entered in the same order as presented clinically, history and pain analysis contained most of the predictive information available. When all factors were entered simultaneously in the computations, the following factors (in order of relative importance) predicted relief of sciatica after 2 years: rupture of the anulus (as opposed to bulging disc or negative exploration), no preoperative comorbidity, and male gender. The following factors predicted return to work at 2 years: no preoperative comorbidity, duration of sciatica less than 7 months, education or vocational training in addition to compulsory school, age younger than 41 years, male gender, and no previous nonspinal surgery. Return to work does not seem to be a valid result parameter in lumbar disc surgery. The most important physical signs were root tension tests and lumbar range of motion, whereas neurologic signs were of secondary importance. Many people have asymptomatic herniations, and today supersensitive diagnostic imaging is widely available. Thus, the importance of clinical evaluation has increased, and most of the relevant information can be obtained by listening to the patient. A simple anamnesis apparently is a good alternative to psychologic tests in surgical triage. PMID:10212604

Vucetic, N; Astrand, P; Güntner, P; Svensson, O

1999-04-01

14

Recurrence of sciatica following hemilaminectomy for disc herniation  

Microsoft Academic Search

This retrospective study investigated the causes of ipsilateral sciatica following formal hemilaminectomy and discectomy for disc herniation and analyzed the factors that influence the outcome of revision surgery for recurrence. From a series of 1,016 patients who were operated upon for primary lumbar disc herniation, 64 patients were revised because of persistent or recurrent sciatica and back pain. Successful outcome

Konstantinos Liaropoulos; Paraskevi Spiropoulou; Nikolaos Papadakis; Th Maraziotis; Panagiotis Korovessis

2003-01-01

15

Low-Back Pain Following Surgery for Lumbar Disc Herniation  

Microsoft Academic Search

Background: Lumbar disc herniation often causes sciatica. Although surgery may provide relief of sciatic pain, it is uncertain how surgery affects the relief of low-back pain. The purpose of the present prospective study was to assess the efficacy of discectomy in the treatment of low-back pain associated with lumbar disc herniation. Methods: Between 1998 and 2001, forty consecutive patients with

TOMOAKI TOYONE; TADASHI TANAKA; DAISUKE KATO; RYUTAKU KANEYAMA

16

Sacral Perineural Cyst Accompanying Disc Herniation  

PubMed Central

Although most of sacral perineural cysts are asymptomatic, some may produce symptoms. Specific radicular pain may be due to distortion, compression, or stretching of nerve root by a space occupying cyst. We report a rare case of S1 radiculopathy caused by sacral perineural cyst accompanying disc herniation. The patient underwent a microscopic discectomy at L5-S1 level. However, the patient's symptoms did not improved. The hypesthesia persisted, as did the right leg pain. Cyst-subarachnoid shunt was set to decompress nerve root and to equalize the cerebrospinal fluid pressure between the cephalad thecal sac and cyst. Immediately after surgery, the patient had no leg pain. After 6 months, the patient still remained free of leg pain.

Ju, Chang Il; Shin, Ho; Kim, Hyeun Sung

2009-01-01

17

Thoracic Disc Herniation Presenting with Transient Anterior Spinal Artery Syndrome  

PubMed Central

Summary This report is a clinical and radiologic correlation of anterior spinal arterial distribution ischemia with a thoracic disc herniation affecting the artery of Adamkiewicz. We could only find one other similar reported case. A 38-year-old woman developed sudden onset of severe back pain and radiculopathy, followed by rapidly evolving paraparesis. The neurological examination was consistent with a deficit caused by anterior spinal artery ischemia. MRI revealed T2 signal change in the thoracolumbar spinal cord and a laterally placed, non-calcified disc herniation. Selective spinal angiography performed 30 hours after onset revealed displacement of the left T9 radicular feeding artery by the disc herniation; at this time the artery was patent. The patient experienced some resolution of symptoms within the first 24 hours and was managed conservatively and made a significant recovery within two weeks. Appropriately located thoracic disc herniations can disturb the blood supply to the thoracolumbar spinal cord.

Guest, J.D.; Griesdale, D.E.; Marotta, T.

2000-01-01

18

Sagittal spinal alignment in patients with lumbar disc herniation  

Microsoft Academic Search

A retrospective cross-sectional study was designed to evaluate total sagittal spinal alignment in patients with lumbar disc\\u000a herniation (LDH) and healthy subjects. Abnormal sagittal spinal alignment could cause persistent low back pain in lumbar disease.\\u000a Previous studies analyzed sciatic scoliotic list in patients with lumbar disc herniation; but there is little or no information\\u000a on the relationship between sagittal alignment

Kenji Endo; Hidekazu Suzuki; Hidetoshi Tanaka; Yupeng Kang; Kengo Yamamoto

2010-01-01

19

Clinical Outcomes of Epidural Neuroplasty for Cervical Disc Herniation  

PubMed Central

Cervical disc herniation is a common disorder characterized by neck pain radiating to the arm and fingers as determined by the affected dermatome. This condition has a favorable prognosis, but pain can have a serious detrimental impact on daily activities. Epidural neuroplasty has been applied as a treatment option for cervical disc herniation; however, no study has addressed the clinical outcomes. This retrospective study evaluated the clinical outcomes of epidural neuroplasty on 128 patients for the treatment of cervical disc herniation. To measure pain-related disabilities over time, the changes of pain scores in neck and arm were evaluated using a numerical rating scale (NRS) and the neck disability index (NDI). Compared with preprocedural values, the pain NRS of neck and arm demonstrated significant improvement at day 1, and 1, 3, 6, and 12 months after the procedure (P < 0.001). Likewise, the NDI was significantly reduced at 3, 6, and 12 months after the procedure (P < 0.001). There were no serious complications. Cervical epidural neuroplasty shows good clinical outcomes in the treatment of cervical disc herniation and can be considered a treatment modality for cervical disc herniation refractory to conservative treatment.

Park, Eun Jung; Park, Sun Young; Lee, Se Jin; Koh, Do Yle

2013-01-01

20

Detection of Residual Disc Hernia Material and Confirmation of Nerve Root Decompression at Lumbar Disc Herniation Surgery by Intraoperative Ultrasound  

Microsoft Academic Search

The aim of lumbar disc herniation surgery is the removal of herniated disc material (HDM) and complete decompression of the nerve root. As some patients present with residual HDM, we examined the ability of intraoperative ultrasound (IOUS) to detect this material. Between February 2006 and June 2007, we used IOUS in 30 patients undergoing surgery for lumbar disc herniation. They

Takeshi Aoyama; Kazutoshi Hida; Minoru Akino; Shunsuke Yano; Yoshinobu Iwasaki

2009-01-01

21

Spontaneous Intracranial Hypotension Secondary to Lumbar Disc Herniation  

PubMed Central

Spontaneous intracranial hypotension is often idiopathic. We report on a patient presenting with symptomatic intracranial hypotension and pain radiating to the right leg caused by a transdural lumbar disc herniation. Magnetic resonance (MR) imaging of the brain revealed classic signs of intracranial hypotension, and an additional spinal MR confirmed a lumbar transdural herniated disc as the cause. The patient was treated with a partial hemilaminectomy and discectomy. We were able to find the source of cerebrospinal fluid leak, and packed it with epidural glue and gelfoam. Postoperatively, the patient's headache and log radiating pain resolved and there was no neurological deficit. Thus, in this case, lumbar disc herniation may have been a cause of spontaneous intracranial hypotension.

Kim, Kyoung-Tae

2010-01-01

22

Percutaneous thoracic intervertebral disc nucleoplasty: technical notes from 3 patients with painful thoracic disc herniations.  

PubMed

Symptomatic thoracic disc herniation is an uncommon condition and early surgical approaches were associated with significant morbidity and even mortality. We are the first to describe the technique of percutaneous thoracic nucleoplasty in three patients with severe radicular pain due to thoracic disc herniation. Two of the patients experienced more than 75% pain relief and one patient experienced more than 50% pain relief. Post-procedural pain relief was maintained up to an average of 10 months after nucleoplasty. One patient with preoperative neurological signs improved postoperatively. There were no reported complications in all three patients. In view of the reduced morbidity and shorter operating time, thoracic intervertebral disc nucleoplasty can be considered in patients with pain due to thoracic disc herniation, with no calcification of the herniated disc, and in patients who may be otherwise be unfit for conventional surgery. PMID:21386942

Chua, Nicholas H L; Gültuna, Ismail; Riezebos, Patricia; Beems, Tjemme; Vissers, Kris C

2011-03-02

23

Percutaneous Thoracic Intervertebral Disc Nucleoplasty: Technical Notes from 3 Patients with Painful Thoracic Disc Herniations  

PubMed Central

Symptomatic thoracic disc herniation is an uncommon condition and early surgical approaches were associated with significant morbidity and even mortality. We are the first to describe the technique of percutaneous thoracic nucleoplasty in three patients with severe radicular pain due to thoracic disc herniation. Two of the patients experienced more than 75% pain relief and one patient experienced more than 50% pain relief. Post-procedural pain relief was maintained up to an average of 10 months after nucleoplasty. One patient with preoperative neurological signs improved postoperatively. There were no reported complications in all three patients. In view of the reduced morbidity and shorter operating time, thoracic intervertebral disc nucleoplasty can be considered in patients with pain due to thoracic disc herniation, with no calcification of the herniated disc, and in patients who may be otherwise be unfit for conventional surgery.

Gultuna, Ismail; Riezebos, Patricia; Beems, Tjemme; Vissers, Kris C.

2011-01-01

24

Relationship between Physical Work Load and Lumbar Disc Herniation.  

PubMed

Lumbar disc herniation (LDH) is a disabling problem. This retrospective case control study was done to evaluate the possible relevance of physical work load with Lumbar Disc Herniation. We have performed this study in the Spinal Surgery Unit of Department of Orthopaedic Surgery at BSMMU, Dhaka from July 2007 to June 2010 where 200 cases with Lumbar Disc Herniation and 200 control subjects matched by age, gender and area of residence were taken and analyzed. Chi-square test was computed for sex, area of residence, type of physical work and effort at work, whereas Odds ratio was computed for physical work load, stress at work and daily working period. The highest odds ratio (OR) was with the physical work load (OR: 03.48, CI: 01.84-06.59), hard work (OR: 03.14, CI: 01.74-05.65) and working period of >8 hours (OR: 01.34, CI: 0.75-02.38). Odds ratio for heavy load carrying at work was 03.48 and less job satisfaction or stress at work was 02.45. There was a statistically significant positive association between cumulative exposure of physical work load and lumbar disc herniation indicating an increased occurrence of herniation in heavy physical work load and occupation requiring harder efforts. PMID:23982545

Ahsan, M K; Matin, T; Ali, M I; Ali, M Y; Awwal, M A; Sakeb, N

2013-07-01

25

Endoscopic Percutaneous Transforaminal Treatment for Herniated Lumbar Discs  

Microsoft Academic Search

Summary.  \\u000a ?Background: The prevailing percutaneous treatment options for herniated non-contained lumbar discs have not reliably achieved the same\\u000a good results as the conventional microsurgical techniques. In this study we evaluated clinical outcome and complication rate\\u000a following endoscopic percutaneous transforaminal treatment of extruded or sequestrated herniated lumbar discs in 122 patients\\u000a with a follow-up period of more than one year.\\u000a \\u000a \\u000a \\u000a ?Method:

S. Eustacchio; G. Flaschka; M. Trummer; I. Fuchs; F. Unger

2002-01-01

26

Intradural tumor and concomitant disc herniation of cervical spine  

PubMed Central

We report a rare patient of a simultaneous extradural and intradural compression of the cervical spinal cord due to co-existent intervertebral disc herniation and an intradural schwannoma at the same level. The intradural lesion was missed resulting in recurrence of myelopathy after a surprisingly complete functional recovery following anterior cervical discectomy. Retrospectively, it was noted that the initial cord swelling noticed was tumor being masked by the compression produced by the herniated disc. A contrast magnetic resonance imaging scan is important in differentiating intradural tumors of the spinal cord. A high index of suspicion is often successful in unmasking both the pathologies.

Bapat, Mihir R; Rathi, Prasanna; Pawar, Uday; Chaudhary, Kshitij

2011-01-01

27

Thoracic venous congestion caused by thoracic disc herniation.  

PubMed

We present what is to our knowledge the first reported case of thoracic disc herniation leading to venous congestive myelopathy (VCM), which was clinically and radiographically suggestive of Foix-Alajouanine syndrome (angiodysgenetic necrotizing myelopathy). In addition, we review current concepts in evaluating the etiology of VCM and discuss indications for surgery. PMID:23785652

Roger, Eric P; Chamczuk, Andrea J; Hagan, Marygrace C

2013-02-17

28

Thoracic venous congestion caused by thoracic disc herniation  

PubMed Central

We present what is to our knowledge the first reported case of thoracic disc herniation leading to venous congestive myelopathy (VCM), which was clinically and radiographically suggestive of Foix–Alajouanine syndrome (angiodysgenetic necrotizing myelopathy). In addition, we review current concepts in evaluating the etiology of VCM and discuss indications for surgery.

Roger, Eric P; Chamczuk, Andrea J; Hagan, Marygrace C

2013-01-01

29

Different Expression of Extracellular Matrix Genes : Primary vs. Recurrent Disc Herniation  

PubMed Central

Objective Recurrent lumbar disc herniation has been reported to occur in 5% to 15% of surgically treated primary lumbar disc herniation cases. We investigated the molecular biologic characteristics of primary herniated discs and recurrent discs to see whether the recurrent discs has the similar biological features with primary herniated discs. Methods Primary herniated disc and recurrent disc cells were obtained by discectomy of lumbar disc patients and cells were isolated and then taken through monolayer cultures. We compared chondrogenic and osteogenic mRNA gene expression, and western blot between the two groups. Results The mRNA gene expression of recurrent disc cells were increased 1.47* times for aggrecan, 1.38 times for type I collagen, 2.04 times for type II collagen, 1.22 times for both Sox-9 and osteocalcin, and 1.31 times for alkaline phosphatase, respectively, compared with the primary herniated lumbar disc cells (*indicates p < 0.05). Western blot results for each aggrecan, type I collagen, type II collagen, Sox-9, osteocalcin, and alkaline phosphatase were similar between the primary herniated disc cells and recurrent disc cells. Conclusion These results indicate that the recurrent disc cells have similar chondrogenic and osteogenic gene expression compared to primary herniated disc cells. Therefore, we assumed that the regeneration of remaining discs could fill the previous discectomy space and also it could be one of the factors for disc recurrence especially in the molecular biologic field.

Kuh, Sung-Uk; Kwon, Young-Min; Chin, Dong-Kyu; Jin, Byung-Ho; Cho, Yong-Eun

2010-01-01

30

Posteriorly migrated thoracic disc herniation: a case report  

PubMed Central

Introduction Posterior epidural migration of thoracic disc herniation is extremely rare but may occur in the same manner as in the lumbar spine. Case presentation A 53-year-old Japanese man experienced sudden onset of incomplete paraplegia after lifting a heavy object. Magnetic resonance imaging revealed a posterior epidural mass compressing the spinal cord at the T9-T10 level. The patient underwent emergency surgery consisting of laminectomy at T9-T10 with right medial facetectomy, removal of the mass lesion, and posterior instrumented fusion. Histological examination of the mass lesion yielded findings consistent with sequestered disc material. His symptoms resolved, and he was able to resume walking without a cane 4 weeks after surgery. Conclusions Pre-operative diagnosis of posterior epidural migration of herniated thoracic disc based on magnetic resonance imaging alone may be overlooked, given the rarity of this pathology. However, this entity should be considered among the differential diagnoses for an enhancing posterior thoracic extradural mass.

2013-01-01

31

Foraminal disc herniation Th9-Th10 mimicking abdominal pain  

Microsoft Academic Search

Thoracic disc herniations (TDH) requiring surgery are rare. They usually present with pain and\\/or myelopathy. Only 6% are wide lateral, either intraforaminal or extraforaminal. A 52-year-old patient presented with chronic mid-thoracic pain, radiating along the left 9th and 10th ribs. After nephrologic and pancreatic diseases had been exclud - ed, a CT-scan showed a far-lateral calcified TDH in the left

Patrick FRANSEN; Frédéric COLLIGNON; Bernard VAN DEN HEULE

2008-01-01

32

Percutaneous cervical nucleoplasty in the treatment of cervical disc herniation.  

PubMed

Percutaneous disc decompression procedures have been performed in the past. Various percutaneous techniques such as percutaneous discectomy, laser discectomy, and nucleoplasty have been successful. Our prospective study was directly to evaluate the results of percutaneous cervical nucleoplasty (PCN) surgery for cervical disc herniation, and illustrate the effectiveness of PCN in symptomatic patients who had cervical herniated discs. From July of 2002 to June of 2005, 126 consecutive patients with contained cervical disc herniations have presented at the authors' clinic and treated by PCN. The patients' gender distribution for PCN was 65 male, 61 female. The age of patients ranged from 34 to 66 years (mean 51.9 +/- 10.2 years). The levels of involvement were 21 cases at C3-4, 30 cases at C4-5, 40 cases at C5-6, and 35 cases at C6-7. The clinical outcomes, pain reduction and the segment stability were all recorded during this study. A clinical outcome was quantified by the Macnab standard and using VAS. The angular displacement (AD) > or =11 degrees or horizontal displacement (HD) > or =3 mm was considered to be radiographically unstable. In the results of this study, puncture of the needle into the disc space was accurately performed under X-ray guidance in all cases. There was one case where the Perc-D Spine Wand had broken in the disc space during the procedure. The partial Perc-D Spine Wand, which had broken in the disc space could not be removed by the percutaneous cervical discectomy and thus remained there. There were no recurrent cases or complications in our series. Macnab standard results were excellent in 62 cases, good in 41 cases and fair in 23 cases. The rate of excellent and good was 83.73%. The VAS scores demonstrated statistically significant improvement in PCN at the 2-week, 1, 3, 6, and 12-month follow-up visits when compared to preoperational values (P < 0.01). There were no cases of instability following the PCN procedure. There was no significant difference in stability either preoperatively or postoperatively (P > 0.05). Our findings confirm that PCN for the treatment of cervical disc herniation results in a good outcome without any tampering of the stability of the cervical spine. Hence, PCN as a procedure is safe, minimally invasive, less traumatic, requiring less time with an excellent clinical outcome. PCN should be performed for those patients who fail conservative medical management including medication, physical therapy, behavioral management, psychotherapy, and who are unwilling to undergo a more invasive technique such as spinal surgery. PMID:18830638

Li, Jian; Yan, Deng-lu; Zhang, Zai-Heng

2008-10-01

33

Percutaneous cervical nucleoplasty in the treatment of cervical disc herniation  

PubMed Central

Percutaneous disc decompression procedures have been performed in the past. Various percutaneous techniques such as percutaneous discectomy, laser discectomy, and nucleoplasty have been successful. Our prospective study was directly to evaluate the results of percutaneous cervical nucleoplasty (PCN) surgery for cervical disc herniation, and illustrate the effectiveness of PCN in symptomatic patients who had cervical herniated discs. From July of 2002 to June of 2005, 126 consecutive patients with contained cervical disc herniations have presented at the authors’ clinic and treated by PCN. The patients’ gender distribution for PCN was 65 male, 61 female. The age of patients ranged from 34 to 66 years (mean 51.9 ± 10.2 years). The levels of involvement were 21 cases at C3–4, 30 cases at C4–5, 40 cases at C5–6, and 35 cases at C6–7. The clinical outcomes, pain reduction and the segment stability were all recorded during this study. A clinical outcome was quantified by the Macnab standard and using VAS. The angular displacement (AD) ?11° or horizontal displacement (HD) ?3 mm was considered to be radiographically unstable. In the results of this study, puncture of the needle into the disc space was accurately performed under X-ray guidance in all cases. There was one case where the Perc-D Spine Wand had broken in the disc space during the procedure. The partial Perc-D Spine Wand, which had broken in the disc space could not be removed by the percutaneous cervical discectomy and thus remained there. There were no recurrent cases or complications in our series. Macnab standard results were excellent in 62 cases, good in 41 cases and fair in 23 cases. The rate of excellent and good was 83.73%. The VAS scores demonstrated statistically significant improvement in PCN at the 2-week, 1, 3, 6, and 12-month follow-up visits when compared to preoperational values (P < 0.01). There were no cases of instability following the PCN procedure. There was no significant difference in stability either preoperatively or postoperatively (P > 0.05). Our findings confirm that PCN for the treatment of cervical disc herniation results in a good outcome without any tampering of the stability of the cervical spine. Hence, PCN as a procedure is safe, minimally invasive, less traumatic, requiring less time with an excellent clinical outcome. PCN should be performed for those patients who fail conservative medical management including medication, physical therapy, behavioral management, psychotherapy, and who are unwilling to undergo a more invasive technique such as spinal surgery.

Li, Jian; Zhang, Zai-Heng

2008-01-01

34

Automatic diagnosis of lumbar disc herniation with shape and appearance features from MRI  

NASA Astrophysics Data System (ADS)

Intervertebral disc herniation is a major reason for lower back pain (LBP), which is the second most common neurological ailment in the United States. Automation of herniated disc diagnosis reduces the large burden on radiologists who have to diagnose hundreds of cases each day using clinical MRI. We present a method for automatic diagnosis of lumbar disc herniation using appearance and shape features. We jointly use the intensity signal for modeling the appearance of herniated disc and the active shape model for modeling the shape of herniated disc. We utilize a Gibbs distribution for classification of discs using appearance and shape features. We use 33 clinical MRI cases of the lumbar area for training and testing both appearance and shape models. We achieve over 91% accuracy in detection of herniation in a cross-validation experiment with specificity of 91% and sensitivity of 94%.

Alomari, Raja's.; Corso, Jason J.; Chaudhary, Vipin; Dhillon, Gurmeet

2010-03-01

35

Relationship between neovascularization and degenerative changes in herniated lumbar intervertebral discs.  

PubMed

PURPOSE: Lumbar disc degeneration may be associated with intensity of neovascularization in disc herniations. Our study was designed to evaluate how much the severity of histodegeneration is related to the development of neovascularization and to the level of pleiotrophin in the herniated lumbar discs. METHODS: Surgically excised lumbar disc specimens were obtained from 29 patients with noncontained (i.e., extruding through the posterior longitudinal ligament) and 21 patients with contained disc herniations. The histodegeneration scores and levels of neovascularization were estimated according to semiquantitative analysis in lumbar disc and endplate samples. Immunohistochemical staining were performed to identify the newly formed blood vessels and to detect the presence of pleiotrophin in the specimens. RESULTS: Higher levels of disc and endplate neovascularity were registered in noncontained herniations. The level of neovascularization was significantly related to the score of histodegeneration in the herniated disc tissues but not in the endplate specimens. Both contained and noncontained herniations had the highest values of histodegeneration in conjunction with the highest level of neovascularization but the relations between neovascularity and degenerative changes remained to be significant only in the group of noncontained herniations. Registration or frequency of pleiotrophin positive cells did not correlate significantly with histodegeneration or level of neovascularization in the disc samples. CONCLUSION: Severe histodegeneration of the lumbar disc herniations is associated with enhanced neovascularization and potentially also spontaneous regression of the herniated tissue. PMID:23736847

Rätsep, Tõnu; Minajeva, Ave; Asser, Toomas

2013-06-01

36

Management of disc herniations with bi-radicular symptoms via combined lateral and interlaminar approach  

Microsoft Academic Search

Large lumbosacral disc herniations causing bi-radicular symptoms are very rare clinical entities and may present a surgical\\u000a challenge. This study was undertaken to evaluate the effectiveness of the simply modified combined lateral and interlaminar\\u000a approach for the treatment of these unique disc herniations. Between 2000 and 2005, 18 patients with bi-radicular symptoms\\u000a secondary to large disc herniations of the lumbar

Murat Kutlay; K?vanç Topuz; Ahmet Çetinkal; Hakan ?im?ek; Mehmet Nusret Demircan

2010-01-01

37

Psychopathological Influence of Lumbar Disc Herniation in Male Adolescent  

PubMed Central

Purpose There is no report about psychopathological effect causing by disc herniation. The disease could impose psychopathological influence on the social life, the treatment period, and response to the treatment. This study was to evaluate retrospectively the psychopathological influence of lumbar disc herniation (LDH) among Korean 19-year-old males. Materials and Methods We compared the Korean military multiphasic personality inventory (KMPI) profiles of 74 LDH cases with the KMPI profiles of 150 controls. The LDH groups were categorized to 2 groups according to the presence of thecal sac compression by disc materials, and evaluated the relation between the KMPI and LDH. Results The decrease of the faking-good response scale and increase of the faking-bad response scale were observed more in the LDH group than in the normal volunteer group (p<0.05). The neurosis set such as anxiety, depression and somatization was markedly increased in the LDH group compared to the normal volunteers group (p<0.05). The scale of personality disorder was also increased more in the LDH group (p=0.002). The differences of KMPI scales were not correlated with the severe pathology of LDH. Conclusion Young male with LDH may tend to have more abnormal results of multiphasic personality inventory test compared to the normal volunteers, suggesting that LDH may be related to the psychopathology in young males in Korea. Therefore, clinicians are recommended to evaluate and treat the psychopathological aspects in patients with LDH.

Kim, Tae Woo; Oh, Chang Hyun; Shim, Yu Sik; Park, Hyeong-chun; Park, Chong Oon

2013-01-01

38

Treatment of lumbar disc herniation in the second decade of life  

Microsoft Academic Search

Lumbar disc herniation is rare in patients under the age of 20 years. In the department of orthopaedic surgery of the University Hospital of Frankfurt, 33 patients below the age of 20 with lumbar disc herniation were treated over a period of 10 years. Eighteen were managed conservatively and 15 surgically. The purpose of this study is to report on

A. A. Kurth; S. Rau; C. Wang; E. Schmitt

1996-01-01

39

Adolescent lumbar disc herniation in a Tae Kwon Do martial artist: a case report  

PubMed Central

Lumbar disc herniations are rare in children. The etiology and clinical picture may be different in children than in adults. Conservative management is the treatment of choice. Tae Kwon Do is a Korean martial art which is notorious for its high fast kicks. Tae Kwon Do will be an official Olympic sport in the year 2000. Low back pain is occasionally reported by Tae Kwon Do athletes but there are no reported cases in the literature on disc herniation in a Tae Kwon Do athlete. A case report is presented to illustrate clinical presentation, diagnosis, radiological assessment and conservative management of lumbar disc herniation in children. ImagesFigure 1Figure 2

Kazemi, Mohsen

1999-01-01

40

Intradural Lumbar Disc Herniation Associated With Degenerative Spine Disease and Rheumatoid Arthritis.  

PubMed

Study Design. A case report by Kara Krajewski and Jan Regelsberger.Objective. To demonstrate a case of intradural lumbar disc herniation including imaging studies, intraoperative imaging and an intraoperative video.Summary of Background Data. The first case of lumbar intradural disc herniation was reported as early as 1942; since then over 150 cases have been reported, mostly in the lumbar spine. Gadolinium-enhanced MRI is considered the gold standard for diagnosing this entity, though it is rarely peformed routinely in lumbar disc disease and diagnosis is often made intraoperatively.Methods. A 70-year-old man presented to the emergency department as a referral complaining of lower back pain, loss of sensation in the right thigh and difficulty walking. On examination, he showed uneven gait, right-sided foot drop (1/5), hypesthesias in the right inguinal area and ventral thigh and a positive straight leg raise test on the right. Anal sphincter tone was within normal limits. An MRI of the lumbar spine showed a large mediolateral herniated disc at L3/4, with caudal displacement and unclear signal changes intradurally.Results. Intraoperatively, the herniated disc was found upon opening the dural sac.Conclusion. Intradural disc herniations are a rare entity. The opening and inspection of the dural sack should be considered when the correct spinal level can be confirmed and insufficient herniated disc material can be visualized extradurally. PMID:23462573

Krajewski, K; Regelsberger, J

2013-03-01

41

Unusual case of camptocormia triggered by lumbar-disc herniation.  

PubMed

A 21-year-old male patient with low back pain and marked forward bending was presented. The exaggerated lumbar flexion was preventing him to stand in erect posture but disappeared while lying. The symptoms had begun after he had lifted a heavy object. Straight-leg-raising test could not be performed properly because of the exaggerated pain. The light-touch sense was decreased on L5 and S1 dermatomes. There was no loss of muscle strength. The deep-tendon reflexes were normal. Plain graph showed mild narrowing in the L4-5 and L5-S1 intervertebral spaces. Lumbar magnetic resonance imaging revealed disc protrusions in L4-5 and L5-S1 levels. During his stay in the department, the patient was given tizanidine and tramadol, and physical therapy was performed. A paravertebral intramuscular injection with lidocaine was applied. Moreover, the patient was referred to psychiatrist for evaluation regarding his medical history of conversive seizures and possible efforts for secondary gain. No response was obtained from all the treatments. The final diagnosis was camptocormia triggered by lumbar-disc herniation. He was applied supportive psychotherapy, psychoeducation regarding secondary gain, strong suggestions to improve posture, positive reinforcement, and behavioral therapy. His postural abnormality resolved and disappeared completely with mild pain. PMID:18087763

Duman, Iltekin; Baklaci, Korhan; Tan, Arif Kenan; Kalyon, Tunc Alp

2007-12-18

42

Intradural herniation of intervertebral disc at the level of Lumbar 1-Lumbar 2.  

PubMed

Intradural disc herniation is a serious and rare complication of intervertebral disc rupture. The preoperative diagnosis of intradural disc herniation is still difficult despite new neuroradiologic investigation possibilities including computerized tomography and magnetic resonance imaging and it is usually diagnosed by during surgery. Here we present an intradural disc herniation case at the level of L1-L2 with accompanying significant myelopathic neurologic deficits. A 50-year-old female patient was admitted to the hospital with pain and weakness in both legs. Her neurological examination revealed paraparesis. Magnetic resonance imaging showed an extruded disc hernia of central localization at the L1-L2 level. She underwent total laminectomy at the level of L1-L2 and her intradural disc fragment was extirpated by microsurgical methods. PMID:17935031

Oztürk, Adil; Avci, Emel; Yazgan, Pelin; Torun, Fuat; Yüceta?, Seyho; Karaba?, Hamza

2007-04-01

43

Clinical features of conjoined lumbosacral nerve roots versus lumbar intervertebral disc herniations  

Microsoft Academic Search

Unidentified nerve root anomalies, conjoined nerve root (CNR) being the most common, may account for some failed spinal surgical\\u000a procedures as well as intraoperative neural injury. Previous studies have failed to clinically discern CNR from herniated\\u000a discs and found their surgical outcomes as being inferior. A comparative study of CNR and disc herniations was undertaken.\\u000a Between 2002 and 2008, 16

R. Lotan; A. Al-Rashdi; A. Yee; J. Finkelstein

2010-01-01

44

Analysis of hard thoracic herniated discs: review of 18 cases operated by thoracoscopy  

Microsoft Academic Search

The authors retrospectively reviewed a series of 18 hard thoracic herniated discs (HTHD) operated by thoracoscopy. Isolated cases of HTHD have been reported in the literature, but no series describing these lesions has been published. Seventy-two percent of the herniated discs were situated between T8 and T12. Fifty-six percent of the patients had radiographic sequelae of Scheuermanns disease. Postoperatively, 83%

Olivier Gille; Christian Soderlund; Henri J. C. Razafimahandri; Paolo Mangione; Jean-Marc Vital

2006-01-01

45

Surgery versus conservative management of sciatica due to a lumbar herniated disc: a systematic review  

Microsoft Academic Search

The effectiveness of surgery in patients with sciatica due to lumbar disc herniations is not without dispute. The goal of\\u000a this study was to assess the effects of surgery versus conservative therapy (including epidural injections) for patients with\\u000a sciatica due to lumbar disc herniation. A comprehensive search was conducted in MEDLINE, EMBASE, CINAHL, CENTRAL, and PEDro\\u000a up to October 2009.

Wilco C. H. JacobsMaurits; Maurits van Tulder; Mark Arts; Sidney M. Rubinstein; Marienke van Middelkoop; Raymond Ostelo; Arianne Verhagen; Bart Koes; Wilco C. Peul

2011-01-01

46

Cervical Disc Herniation Causing Brown-Séquard's Syndrome: A Case Report and Literature Review.  

PubMed

Brown-Séquard's syndrome (BSS) is caused by hemisection or hemicompression of the cord leading to ipsilateral motor deficit and contralateral sensory loss. Cervical disc herniation has been reported to be a rare cause of Brown-Séquard's syndrome. We describe a rare case of multilevel cervical disc herniation presenting as BSS. The condition was confirmed by MRI scan. Cervical corpectomy, decompression, and fusion gave a satisfying result. Pertinent literature has been reviewed. PMID:23259105

Rustagi, Tarush; Badve, Siddharth; Maniar, Hemil; Parekh, Aseem N

2012-01-22

47

Cervical Disc Herniation Causing Brown-S?quard's Syndrome: A Case Report and Literature Review  

PubMed Central

Brown-Séquard's syndrome (BSS) is caused by hemisection or hemicompression of the cord leading to ipsilateral motor deficit and contralateral sensory loss. Cervical disc herniation has been reported to be a rare cause of Brown-Séquard's syndrome. We describe a rare case of multilevel cervical disc herniation presenting as BSS. The condition was confirmed by MRI scan. Cervical corpectomy, decompression, and fusion gave a satisfying result. Pertinent literature has been reviewed.

Rustagi, Tarush; Badve, Siddharth; Maniar, Hemil; Parekh, Aseem N.

2011-01-01

48

The clinical effect of herbal magnetic corsets on lumbar disc herniation  

Microsoft Academic Search

Objective: To determine the clinical effects of the treatment of lumbar disc herniation with herbal magnetic corsets.Design: A randomized control trial.Setting: The outpatient and inpatient departments of the Rehabilitation Center of the West China Hospital.Patients: Sixty patients with clinically diagnosed lumbar disc herniation were included in the study.Interventions: Both groups received lumbar traction, medium frequency electrotherapy and massage, whereas the

Chengqi He; Peng Chen; Xiaohong Wang; Mingfu Ding; Qun Lan; Mei Han

2006-01-01

49

Proinflammatory cytokines in cerebrospinal fluid and serum in patients with disc herniation and sciatica  

Microsoft Academic Search

Proinflammatory cytokines have been identified in herniated intervertebral discs in humans, and such cytokines have experimentally been demonstrated to be important in the pathophysiological mechanisms of disc herniation. Cerebrospinal fluid (CSF) and serum concentrations of interleukin (IL)-1#, IL-6, IL-8, interferon (IFN)-% and tumour necrosis factor (TNF)-! were investigated using the enzyme-linked immunosorbent assay (ELISA) technique in 39 patients with lumbar

H. Brisby; K. Olmarker; K. Larsson; M. Nutu; B. Rydevik

2002-01-01

50

Who should have Surgery for an Intervertebral Disc Herniation?  

PubMed Central

Study Design Combined prospective randomized controlled trial and observational cohort study of intervertebral disc herniation (IDH), an as-treated analysis. Objective To determine modifiers of the treatment effect (TE) of surgery (the difference between surgical and nonoperative outcomes) for intervertebral disc herniation (IDH) using subgroup analysis. Summary of Background Data SPORT demonstrated a positive surgical TE for IDH at the group level. However, individual characteristics may affect TE. No prior studies have evaluated TE modifiers in IDH. Methods IDH patients underwent either discectomy (n=788) or nonoperative care (n=404) and were analyzed according to treatment received. Thirty-seven baseline variables were used to define subgroups for calculating the time-weighted average TE for the Oswestry Disability Index (ODI) over 4 years (TE=?ODIsurgery-?ODInonoperative). Variables with significant subgroup by* treatment interactions (p<0.1) were simultaneously entered into a multivariate model to select independent TE predictors. Results All analyzed subgroups improved significantly more with surgery than with nonoperative treatment (p<0.05). In minimally adjusted univariate analyses: being married, absence of joint problems, worsening symptom trend at baseline, high school education or less, older age, no worker’s compensation, longer duration of symptoms, and an SF-36 mental component score (MCS) less than 35 were associated with greater TEs. Multivariate analysis demonstrated: being married (TE ?15.8 vs. ?7.7 single, p<0.001), absence of joint problems (TE ?14.6 vs. ?10.3 joint problems, p=0.012), and worsening symptoms (TE ?15.9 vs. ?11.8 stable symptoms, p=0.032) were independent TE modifiers. TE’s were greatest in married patients with worsening symptoms (?18.3) vs. single patients with stable symptoms (?7.8). Conclusions IDH patients who met strict inclusion criteria improved more with surgery than with nonoperative treatment, regardless of specific characteristics. However, being married, without joint problems, and worsening symptom trend at baseline were associated with a greater treatment effect.

Pearson, Adam; Lurie, Jon; Tosteson, Tor; Zhao, Wenyan; Abdu, William; Mirza, Sohail; Weinstein, James

2012-01-01

51

Hemilaminoplasty for the treatment of lumbar disc herniation.  

PubMed

The aim of this study was to evaluate the clinical outcome of the hemilaminoplasty technique for the treatment of lumbar disc herniation (LDH). Forty-three cases of single-level LDH underwent a discectomy and hemilaminoplasty procedure. The preoperative JOA score and VAS of lower back and leg pain were 10.4+/-1.3, 7.8+/-2.1, and 8.6+/-1.7, respectively. The Cobb angle of lumbar sagittal alignment was 10.1+/-2.0. Twenty-five patients who agreed to lumbar discectomy through fenestration were enrolled as the control group. The postoperative JOA score and VAS of low back and leg pain of the hemilaminoplasty group were 19.4+/-1.3, 1.4+/-0.4, and 2.1+/-0.5, respectively. The Cobb angle was 29.2+/-1.9 degrees. There was no epidural scar observed in any of the patients. The Cobb angle of the hemilaminoplasty group was higher than that of the control group (p < 0.05), while the VAS was significantly lower (p < 0.05). Hemilaminoplasty is a useful method to improve clinical outcome, prevent epidural scar, and preserve the normal alignment of lumbar spine. PMID:18636258

Xinyu, Liu; Yanping, Zheng; Jianmin, Li; Liangtai, Gong

2008-07-18

52

Interference of Detection Rate of Lumbar Disc Herniation by Socioeconomic Status  

PubMed Central

Study Design Retrospective study. Purpose The objective of the study is to evaluate the relationship between the detection rate of lumbar disc herniation and socioeconomic status. Overview of Literature Income is one important determinant of public health. Yet, there are no reports about the relationship between socioeconomic status and the detective rate of disc herniation. Methods In this study, 443 cases were checked for lumbar computed tomography for lumbar disc herniation, and they reviewed questionnaires about their socioeconomic status, the presence of back pain or radiating pain and the presence of a medical certificate (to check the medical or surgical treatment for the pain) during the Korean conscription. Results Without the consideration for the presence of a medical certificate, there was no difference in spinal physical grade according to socioeconomic status (p=0.290). But, with the consideration of the presence of a medical certificate, the significant statistical differences were observed according to socioeconomic status in 249 cases in the presence of a medical certificate (p=0.028). There was a lower detection rate in low economic status individuals than those in the high economic class. The common reason for not submitting a medical certificate is that it is neither necessary for the people of lower socioeconomic status nor is it financially affordable. Conclusions The prevalence of lumbar disc herniation is not different according to socioeconomic status, but the detective rate was affected by socioeconomic status. Socioeconomic status is an important factor for detecting lumbar disc herniation.

Ji, Gyu Yeul; Jung, Nak-Yong; An, Seong Dae; Choi, Won-Seok; Kim, Jung Hoon

2013-01-01

53

Lumbar Disc Herniation Associated with Contralateral Neurological Deficit: Can Venous Congestion Be the Cause?  

PubMed Central

Lumbar disc herniation (LDH) associated with a contralateral neurological deficit is sometimes encountered by surgeons. Compression against the opposite pedicle in case of a large discal herniation and prominent stenotic changes of contralateral side are held responsible for contralateral symptoms and findings. In this study, we report a case of LDH associated with a painless contralateral neurological deficit. Prominent venous engorgement and congestion at the contralateral side of discal herniation were detected during the operation. It's treatment with bipolar coagulation and significant improvement was seen after the operation.

Kizmazoglu, Ceren; Ozer, Ercan; Arda, Mehmet Nuri

2013-01-01

54

Is there any relationship between proinflammatory mediator levels in disc material and myelopathy with cervical disc herniation and spondylosis? A non-randomized, prospective clinical study  

Microsoft Academic Search

The proinflammatory mediator (PIM) levels were assessed in surgically removed samples of herniated cervical intervertebral\\u000a discs. The objective of this study was to investigate if there is a correlation between the levels of PIMs in disc material\\u000a and myelopathy associated with cervical intervertebral disc herniation and spondylosis. The role of proinflammatory mediators\\u000a in the degeneration of intervertebral disc and the

Mehmet Nusret Demircan; Alparslan Asir; Ahmet Cetinkal; Nursal Gedik; Ahmet Murat Kutlay; Ahmet Çolak; Sedat Kurtar; Hakan Simsek

2007-01-01

55

Plasma disc decompression for contained cervical disc herniation: a randomized, controlled trial  

PubMed Central

Prospective case series studies have shown that plasma disc decompression (PDD) using the COBLATION SpineWand device (ArthroCare Corporation, Austin, TX) is effective for decompressing the disc nucleus in symptomatic contained cervical disc herniations. This prospective, randomized controlled clinical trial was conducted to evaluate the clinical outcomes of percutaneous PDD as compared to conservative care (CC) through 1 year. Patients (n = 115) had neck/arm pain >50 on the visual analog scale (VAS) pain scale and had failed at least 30 days of failed CC. Patients were randomly assigned to receive either PDD (n = 62) or CC (n = 58). Clinical outcome was determined by VAS pain score, neck disability index (NDI) score, and SF-36 health survey, collected at 6 weeks, 3 months, 6 months, and 1 year. The PDD group had significantly lower VAS pain scores at all follow-up time points (PDD vs. CC: 6 weeks, ?46.87 ± 2.71 vs. ?15.26 ± 1.97; 3 months, ?53.16 ± 2.74 vs. ?30.45 ± 2.59; 6 months, ?56.22 ± 2.63 vs. ?40.26 ± 2.56; 1 year, ?65.73 ± 2.24 vs. ?36.45 ± 2.86; GEE, P < 0.0001). PDD patients also had significant NDI score improvement over baseline when compared to CC patients at the 6 weeks (PDD vs. CC: ?9.15 ± 1.06 vs. ?4.61 ± 0.53, P < 0.0001) and 1 year (PDD vs. CC: ?16.70 ± 0.29 vs. ?12.40 ± 1.26, P = 0.005) follow-ups. PDD patients showed statistically significant improvement over baseline in SF-36 physical component summary scores when compared to CC patients at 6 weeks and 1 year (PDD vs. CC: 8.86 + 8.04 vs. 4.24 ± 3.79, P = 0.0004; 17.64 ± 10.37 vs. 10.50 ± 10.6, P = 0.0003, respectively). In patients who had neck/arm pain due to a contained cervical disc herniation, PDD was associated with significantly better clinical outcomes than a CC regimen. At 1 year, CC patients appeared to suffer a “relapse, showing signs of decline in most measurements, whereas PDD patients showed continued stable improvement.

Nardi, Pier Vittorio

2009-01-01

56

A germane link between piriformis muscle atrophy and lumbar disc herniation.  

PubMed

This article reports the case of a a 29-year-old girl with a right-sided sciatica. Magnetic resonance imaging of the lumbar vertebrae and the pelvic region detected a right L5-S paracentral disc herniation with descending S1 nerve root compression and atrophy in the right piriformis muscle. Magnetic resonance images of two other subjects -one with a known diagnosis of lumbosacral nerve root compression and one healthy individual without any low back pathology were also used in comparison. To the best knowledge of the authors, piriformis muscle atrophy associated with lumbar disc herniation is discussed for the first time in the Literature. PMID:19156020

Malas, F U; Ozçakar, L; Kerimoõlu, U; Yörübulut, M

2009-03-01

57

A review of current treatment for lumbar disc herniation in children and adolescents  

Microsoft Academic Search

Lumbar disc herniation (LDH) is a common disorder among adults with degenerated lumbar intervertebral discs. However, its\\u000a occurrence in childhood and adolescence is much less frequent mostly because children and adolescents tend to have a healthier\\u000a lumbar spine as compared with adults. This difference indicates that children and adolescents are far from being just little\\u000a adults. Over the years, there

Lei Dang; Zhongjun Liu

2010-01-01

58

Genotypic and Antimicrobial Characterisation of Propionibacterium acnes Isolates from Surgically Excised Lumbar Disc Herniations  

PubMed Central

The anaerobic skin commensal Propionibacterium acnes is an underestimated cause of human infections and clinical conditions. Previous studies have suggested a role for the bacterium in lumbar disc herniation and infection. To further investigate this, five biopsy samples were surgically excised from each of 64 patients with lumbar disc herniation. P. acnes and other bacteria were detected by anaerobic culture, followed by biochemical and PCR-based identification. In total, 24/64 (38%) patients had evidence of P. acnes in their excised herniated disc tissue. Using recA and mAb typing methods, 52% of the isolates were type II (50% of culture-positive patients), while type IA strains accounted for 28% of isolates (42% patients). Type III (11% isolates; 21% patients) and type IB strains (9% isolates; 17% patients) were detected less frequently. The MIC values for all isolates were lowest for amoxicillin, ciprofloxacin, erythromycin, rifampicin, tetracycline, and vancomycin (?1mg/L). The MIC for fusidic acid was 1-2 mg/L. The MIC for trimethoprim and gentamicin was 2 to ?4?mg/L. The demonstration that type II and III strains, which are not frequently recovered from skin, predominated within our isolate collection (63%) suggests that the role of P. acnes in lumbar disc herniation should not be readily dismissed.

Rollason, Jess; Albert, Hanne B.; Barnard, Emma; Worthington, Tony; Hilton, Anthony C.; Vernallis, Ann; Patrick, Sheila; Elliott, Tom

2013-01-01

59

Is preoperative occupation related to long-term pain in patients operated for lumbar disc herniation?  

Microsoft Academic Search

Lumbar disc herniation (LDH) is a common cause of back and sciatic pain. When clinical treat- ment fails, surgery may be indicated in selected patients. Although surgery is effective in most cases, some of these patients may have a poor outcome. Different factors may influence these results and poor adap- tation at work is one well-known cause of treatment failure.

Daniel Benzecry Almeida; Paola Hesse Poletto; Jerônimo Buzetti Milano; André Giacomelli Leal; Ricardo Ramina

2007-01-01

60

Surgical discectomy for lumbar disc herniation: surgical techniques.  

PubMed

Discectomy for lumbar discal herniation is the most commonly performed spinal surgery. The basic principle of the various techniques is to relieve the nerve root compression induced by the herniation. Initially, the approach was a unilateral posterior 5-cm incision: the multifidus was detached from the vertebra, giving access through an interlaminar space in case of posterolateral herniation; an alternative paraspinal approach was used for extraforaminal herniation. Over the past 30 years, many technical improvements have decreased operative trauma by reducing incision size, thereby reducing postoperative pain and hospital stay and time off work, while improving clinical outcome. Magnification and illumination systems by microscope and endoscope have been introduced to enable minimally invasive techniques. Several comparative studies have analyzed the clinical results of these various techniques. Although the methodology of most of these studies is debatable, all approaches seem to provide clinical outcomes of similar quality. At all events, minimally invasive techniques reduce hospital stay. While technical proficiency is essential, the final result depends on strict compliance with a prerequisite for surgical indication: close correlation between clinical symptoms and radiological findings. It is essential to discuss the risk/benefit ratio and explain the pros and cons of the recommended technique to the patient. PMID:23352565

Blamoutier, A

2013-01-24

61

The natural history of lumbar disc herniation and radiculopathy  

Microsoft Academic Search

The majority of patients suffering from a radiculopathy caused by a herniated nucleus pulposus (HNP) heal spontaneously without surgery or chemonucleolysis. The clinical course of the radiculopathy varies as well as the efficacy of conservative treatment. In some patients the symptoms decline after a week or two; in others the pain may continue for many months or years. Despite an

Michel Benoist

2002-01-01

62

Reoperations after first lumbar disc herniation surgery; a special interest on residives during a 5-year follow-up  

PubMed Central

Background The overall rate of operations after recurrent lumbar disc herniation has been shown to be 3–11%. However, little is known about the rate of residives. Thus the aim of this study was to explore the cumulative rates of re-operations and especially residive disc herniations at the same side and level as the primary disc herniation after first lumbar disc herniation surgery and the factors that influence the risk of re-operations over a five year follow-up study. Methods 166 virgin lumbar disc herniation patients (mean age 42 years, 57% males) were studied. Data on patients' initial disc operations and type and timing of re-operations during the follow-up were collected from patient files. Back and leg pain on visual analog scale and employment status were collected by questionnaires. Results The cumulative rate of re-operations for lumbar disc herniation was 10.2% (95% Cl 6.0 to 15.1). The rate of residives at initial site was 7.4% (95% Cl 3.7 to 11.3) and rate of lumbar disc herniations at other sites was 3.1% (95% Cl 0.6 to 6.2). The occurrence of residive lumbar disc herniations was evenly distributed across the 5 years. Neither age, gender, preoperative symptoms, physical activity nor employment had effect on the probability of re-operation. Conclusion Seven percent of the lumbar disc patients had a residive lumbar disc operation within five years of their first operation. No specific factors influencing the risk for re-operation were found.

Hakkinen, Arja; Kiviranta, Ilkka; Neva, Marko H; Kautiainen, Hannu; Ylinen, Jari

2007-01-01

63

Retrolisthesis and lumbar disc herniation: a postoperative assessment of patient function  

PubMed Central

BACKGROUND CONTEXT The presence of retrolisthesis has been associated with the degenerative changes of the lumbar spine. However, retrolisthesis in patients with L5–S1 disc herniation has not been shown to have a significant relationship with worse baseline pain or function. Whether it can affect the outcomes after discectomy, is yet to be established. PURPOSE The purpose of this study was to determine the relationship between retrolisthesis (alone or in combination with other degenerative conditions) and postoperative low back pain, physical function, and quality of life. This study was intended to be a follow-up to a previous investigation that looked at the preoperative assessment of patient function in those with retrolisthesis and lumbar disc herniation. STUDY DESIGN Cross-sectional study. PATIENT SAMPLE Patients enrolled in SPORT (Spine Patient Outcomes Research Trial) who had undergone L5–S1 discectomy and had a complete magnetic resonance imaging scan available for review (n=125). Individuals with anterolisthesis were excluded. OUTCOME MEASURES Time-weighted averages over 4 years for the Short Form (SF)-36 bodily pain scale, SF-36 physical function scale, Oswestry Disability Index (ODI), and Sciatica Bothersomeness Index (SBI). METHODS Retrolisthesis was defined as a posterior subluxation of 8% or more. Disc degeneration was defined as any loss of disc signal on T2 imaging. Modic changes were graded 1 to 3 and collectively classified as vertebral end plate degenerative changes. The presence of facet arthropathy and ligamentum flavum hypertrophy was classified jointly as posterior degenerative changes. Longitudinal regression models were used to compare the time-weighted outcomes over 4 years. RESULTS Patients with retrolisthesis did significantly worse with regard to bodily pain and physical function over 4 years. However, there were no significant differences in terms of ODI or SBI. Similarly, retrolisthesis was not a significant factor in the operative time, blood loss, lengths of stay, complications, rate of additional spine surgeries, or recurrent disc herniations. Disc degeneration, modic changes, and posterior degenerative changes did not affect the outcomes. CONCLUSIONS Although retrolisthesis in patients with L5–S1 disc herniation did not affect the baseline pain or function, postoperative outcomes appeared to be somewhat worse. It is possible that the contribution of pain or dysfunction related to retrolisthesis became more evident after removal of the disc herniation.

Kang, Kevin K.; Shen, Michael S.; Zhao, Wenyan; Lurie, Jon D.; Razi, Afshin E.

2013-01-01

64

Clinical factors of importance for outcome after lumbar disc herniation surgery: long-term follow-up  

Microsoft Academic Search

Factors as age, sex, smoking, duration of leg pain, working status, type\\/level of disc herniation and psychosocial factors\\u000a have been demonstrated to be of importance for short-term results after lumbar discectomy. There are few studies with long-term\\u000a follow-up. In this prospective study of lumbar disc herniation patients undergoing surgery, the result was evaluated at 2\\u000a and 5–10 (mean 7.3) years

Katarina Silverplats; B. Lind; B. Zoëga; K. Halldin; M. Gellerstedt; H. Brisby; L. Rutberg

2010-01-01

65

The Impact of Epidural Steroid Injections on the Outcomes of Patients Treated for Lumbar Disc Herniation  

PubMed Central

Background: The Spine Patient Outcomes Research Trial (SPORT) is a prospective, multicenter study of operative versus nonoperative treatment of lumbar intervertebral disc herniation. It has been suggested that epidural steroid injections may help improve patient outcomes and lower the rate of crossover to surgical treatment. Methods: One hundred and fifty-four patients included in the intervertebral disc herniation arm of the SPORT who had received an epidural steroid injection during the first three months of the study and no injection prior to the study (the ESI group) were compared with 453 patients who had not received an injection during the first three months of the study or prior to the study (the No-ESI group). Results: There was a significant difference in the preference for surgery between groups (19% in the ESI group compared with 56% in the No-ESI group, p < 0.001). There was no difference in primary or secondary outcome measures at four years between the groups. A higher percentage of patients changed from surgical to nonsurgical treatment in the ESI group (41% versus 12% in the No-ESI, p < 0.001). Conclusions: Patients with lumbar disc herniation treated with epidural steroid injection had no improvement in short or long-term outcomes compared with patients who were not treated with epidural steroid injection. There was a higher prevalence of crossover to nonsurgical treatment among surgically assigned ESI-group patients, although this was confounded by the increased baseline desire to avoid surgery among patients in the ESI group. Given these data, we concluded that more studies are necessary to establish the value of epidural steroid injection for symptomatic lumbar intervertebral disc herniation. Level of Evidence: Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.

Radcliff, Kristen; Hilibrand, Alan; Lurie, Jon D.; Tosteson, Tor D.; Delasotta, Lawrence; Rihn, Jeffrey; Zhao, Wenyan; Vaccaro, Alexander; Albert, Todd J.; Weinstein, James N.

2012-01-01

66

A rare case of Brown-Sequard syndrome caused by cervical disc herniation: a case report  

PubMed Central

Abstract: Brown-Sequard syndrome is a rare neurological disorder characterized by ipsilateral motor paralysis caused by a lesion through corticospinal tract and contralateral loss of pain and temperature sensation due to the involvement of spinothalamic tract. Cervical disc herniation has been reported to be a rare cause of Brown-Séquard's syndrome. This paper aims to report a case of Brown-Sequard syndrome that occurred in a patient suffering from CHD. In this case, using a rapid and urgent intervention we could prevent permanent neurologic deficit in the patient. Case: A 56-year-old woman complained about a sudden paresis in her right leg lasting for 4 days. Her pain was progressively worsening until she couldn’t walk without assistance. There was no history of trauma in the neck. Neurological examinations revealed right side spastic hemi-paresis as well as loss of pain and temperature sensation below T4 dermatome in the left side. The case was diagnosed as Brown-Sequard syndrome and cervical magnetic resonance imaging scan showed a disc herniation at C5/C6 and C6/C7 levels. Surgery was performed via anterior cervical microdiscectomy and fusion. After a 2-month period of follow-up, neurological assessments showed that motor and sensory functions of the patient returned to the normal condition. Although cervical disc herniation as a cause of Brown-Sequard syndrome is relatively rare, early diagnosis accompanied by an urgent treatment can prevent neurological complications in such cases. Keywords: Brown-Sequard Syndrome, Cervical Disc Herniation, Surgery, Ipsilateral motor paralysis

Ghasemi, Amir Abbas

2012-01-01

67

Reversible propriospinal myoclonus due to thoracic disc herniation: long-term follow-up.  

PubMed

PSM is a rare form of myoclonus of spinal origin. The thoracic level is considered as the myoclonic generator in most cases; however, structural abnormality in conventional magnetic resonance imaging (MRI) related to PSM is more rare. We report the case of a 23-year-old man with PSM with ventral thoracic disc herniation confirmed by conventional MRI, which completely resolved after thoracic discectomy. This case indicates that decompressive surgery might be a valid treatment option. PMID:22014609

Jang, Wooyoung; Kim, Joong-Seok; Ahn, Jin Young; Kim, Hee-Tae

2011-10-20

68

Computed Tomography Fluoroscopy-Guided Selective Nerve Root Block for Acute Cervical Disc Herniation  

PubMed Central

Objective To analyze the clinical outcomes of computed tomography (CT) fluoroscopy-guided selective nerve root block (SNRB) for severe arm pain caused by acute cervical disc herniation. Methods The authors analyzed the data obtained from 25 consecutive patients who underwent CT fluoroscopy-guided SNRB for severe arm pain, i.e., a visual analogue scale (VAS) score of 8 points or more, caused by acute soft cervical disc herniation. Patients with chronic arm pain, motor weakness, and/or hard disc herniation were excluded. Results The series comprised 19 men and 6 women whose mean age was 48.1 years (range 35-72 years). The mean symptom duration was 17.5 days (range 4-56 days) and the treated level was at C5-6 in 13 patients, C6-7 in 9, and both C5-6 and C6-7 in 3. Twenty-three patients underwent SNRB in 1 session and 2 underwent the procedure in 2 sessions. No complications related to the procedures occurred. At a mean follow-up duration of 11.5 months (range 6-22 months), the mean VAS score and NDI significantly improved from 9 and 58.2 to 3.4 and 28.1, respectively. Eighteen out of 25 patients (72%) showed successful clinical results. Seven patients (28%) did not improve after the procedure, and 5 of these 7 underwent subsequent anterior cervical discectomy and fusion. Conclusion CT fluoroscopy-guided SNRB may play a role as a primary conservative treatment for severe arm pain caused by acute cervical disc herniation.

Eun, Sang Soo; Chang, Won Sok; Bae, Sang Jin; Lee, Sang-Ho

2010-01-01

69

Atypical presentation of thoracic disc herniation: case series and review of the literature.  

PubMed

Modern imaging has revealed that thoracic disc herniation (TDH) has a prevalence of 11-37% in asymptomatic patients. Pain, sensory disturbances, myelopathy, and lower extremity weakness are the most common presenting symptoms, but other atypical extraspinal complaints, such as gastrointestinal or cardiopulmonary discomfort, may be reported. Our objective is to make providers familiar with TDH's atypical symptoms to help avoid potential serious consequences created by a delay in diagnosis. We report the cases of two patients who each presented with atypical extraspinal symptoms secondary to a TDH. One patient presented with a chronic history of nausea, emesis, and chest tightness and MRI showed a large right paramedian disc herniation at T7-8. A second patient reported chronic constipation, buttock and leg burning pain, gait instability, and urinary frequency; an MRI of his thoracic spine demonstrated a central disc herniation at T10-11. TDH can present with vague extraspinal symptoms and unfamiliarity with these symptoms can lead to misdiagnosis with progression of the disease and unnecessary diagnostic tests and medical procedures. Therefore, TDH should be included in the differential diagnosis of patients with negative gastrointestinal, genitourinary, and cardiopulmonary system basic studies. PMID:23691393

Shirzadi, Ali; Drazin, Doniel; Jeswani, Sunil; Lovely, Leah; Liu, John

2013-04-04

70

Effects of human midkine on spontaneous resorption of herniated intervertebral discs.  

PubMed

This study was performed in 36 rabbits to investigate the role of midkine (MK) in the resorption of herniated intervertebral discs. The L(1-2) disc was excised and immersed in one of three kinds of solution for two hours before relocation into the L4 epidural space. In the MK-treated group, the weight of relocated intervertebral discs decreased more over time than in the control group. Newly formed vessels and inflammatory cells were more frequently observed in the MK-treated group than in the control group two weeks after surgery. The degradation of matrix was more significant in the MK-treated group than in the control group four weeks after surgery. Larger areas were replaced by fibrous tissues in the MK-treated group eight weeks after surgery. Thus, MK can accelerate the resorption of the intervertebral disc relocation to the epidural space. Epidural injection of MK may contribute to the therapy of lumber disc herniation. PMID:19277655

Zhou, Guoshun; Dai, Licheng; Jiang, Xuesheng; Ma, Zhihong; Ping, Jinliang; Li, Jianyou; Li, Xiongfeng

2009-03-11

71

Effects of human midkine on spontaneous resorption of herniated intervertebral discs  

PubMed Central

This study was performed in 36 rabbits to investigate the role of midkine (MK) in the resorption of herniated intervertebral discs. The L1-2 disc was excised and immersed in one of three kinds of solution for two hours before relocation into the L4 epidural space. In the MK-treated group, the weight of relocated intervertebral discs decreased more over time than in the control group. Newly formed vessels and inflammatory cells were more frequently observed in the MK-treated group than in the control group two weeks after surgery. The degradation of matrix was more significant in the MK-treated group than in the control group four weeks after surgery. Larger areas were replaced by fibrous tissues in the MK-treated group eight weeks after surgery. Thus, MK can accelerate the resorption of the intervertebral disc relocation to the epidural space. Epidural injection of MK may contribute to the therapy of lumber disc herniation.

Jiang, Xuesheng; Ma, Zhihong; Ping, Jinliang; Li, Jianyou; Li, Xiongfeng

2009-01-01

72

Effectiveness of percutaneous laser disc decompression versus conventional open discectomy in the treatment of lumbar disc herniation; design of a prospective randomized controlled trial  

Microsoft Academic Search

BACKGROUND: The usual surgical treatment of refractory sciatica caused by lumbar disc herniation, is open discectomy. Minimally invasive procedures, including percutaneous therapies under local anesthesia, are increasingly gaining attention. One of these treatments is Percutaneous Laser Disc Decompression (PLDD). This treatment can be carried out in an outpatient setting and swift recovery and return to daily routine are suggested. Thus

Patrick A Brouwer; Wilco C Peul; Ronald Brand; Mark P Arts; Bart W Koes; A van den Annette Berg; Mark A van Buchem

2009-01-01

73

Case-control Study of Risk Factors for Lumbar Intervertebral Disc Herniation in Croatian Island Populations  

PubMed Central

Aim To investigate the risk factors for lumbar intervertebral disc herniation (L4/L5 or L5/S1) severe enough to require surgery of the lower spine among 9 isolated populations of Croatian islands and to evaluate predictive value, sensitivity, and specificity of a simple screening test based on the understanding of the risk factors in this population. Methods In a sample of 1001 examinees from Croatian island populations, we identified all subjects who underwent surgery of the lower spine due to lumbar intervertebral disc herniation L4/L5 or L5/S1 and selected 4 controls matched by age, gender, and village of residence for each of them. Odds ratio was computed for the following variables: body mass index, occupation, intensity of physical labor at work, intensity of physical labor at home, smoking index, claudication index, self-assessed limitation in physical activity, level of education, socio-economic status, and family history of lumbar intervertebral disc herniation requiring surgery. Results Comparison of 67 identified cases with 268 controls revealed the highest odds ratios (OR) for positive family history (OR 4.00; 95% confidence intervals [CI], 1.89-6.11, P<0.001), intensity of physical labor at work defined as “hard” (OR 2.94; 95% CI, 1.07-4.81, P<0.001), and body mass index of 25.7 or more (OR 2.77, 95% CI, 1.05-4.49, P?=?0.002). A simple screening test based on the presence of any two of these three criteria has 74% sensitivity and 82% specificity to detect persons who underwent lower spine surgery due to lumbar intervertebral disc herniation in the population aged 40 years or more. Conclusion Occurrence of lumbar disk herniation severe enough to require surgery of the lower spine can be predicted using a very simple set of criteria. This type of screening could reduce the need for surgery in isolated communities through prevention within primary health care.

Saftic, Robert; Grgic, Matijana; Ebling, Barbara; Splavski, Bruno

2006-01-01

74

Acute Paraplegia Secondary to Thoracic Disc Herniation of the Adjacent Segment Following Thoracolumbar Fusion and Instrumentation  

PubMed Central

Proximal junctional disease is a well-recognized postoperative phenomenon in adults who are undergoing long thoracolumbar fusion and instrumentation, and is attributed to increased a junctional stress concentration. In general, the onset of symptoms in these patients is insidious and the disease progresses slowly. We report on a contrary case of rapidly progressing paraplegia secondary to acute disc herniation at the proximal adjacent segment after long posterior thoracolumbar fusion with cement augmentation at the upper instrumented vertebra and the supra-adjacent vertebra. The patient was treated with a discectomy through the costo-transverse approach combined with extension of the posterior instrumentation. The patient's neurological status improved markedly. Stress concentration at the proximal junction disc space may have caused accelerated disc degeneration which in turn lead to this complication.

Assaker, Richard; Musharrafieh, Ramzi Sharif

2013-01-01

75

Endoscopic Transforaminal Suprapedicular Approach in High Grade Inferior Migrated Lumbar Disc Herniation  

PubMed Central

Objective Although endoscopic procedures for lumbar disc diseases have improved greatly, the postoperative outcomes for high grade inferior migrated discs are not satisfactory. Because of anatomic limitations, a rigid endoscope cannot reach all lesions effectively. The purpose of this study was to determine the feasibility of endoscopic transforaminal suprapedicular approach to high grade inferior-migrated lumbar disc herniations. Methods Between May 2006 and March 2008, a suprapedicular approach was performed in 53 patients with high grade inferior-migrated lumbar disc herniations using a rigid endoscope and a semi-rigid flexible curved probe. One-to-four hours after surgery, the presence of remnant discs was checked with MRI. The outcomes were evaluated with the visual analogue scale (VAS) score and the Oswestry Disability Index (ODI) one week after surgery. Results The L2-3 level was involved in 2 patients and the L3-4 level was involved in 14 patients, while the L4-5 level was involved in 39 patients. There were single piece-type in 34 cases and a multiple piece-type in 19 cases. Satisfactory results were obtained in all cases. The mean preoperative VAS for leg pain was 9.32±0.43 points (range, 7-10 points), whereas the mean ODI was 79.82±4.53 points (range, 68-92 points). At the last follow-up examination, the mean postoperative VAS for leg pain was 1.78±0.71 points and the mean postoperative ODI improved to 15.27±3.82 points. Conclusion A high grade inferior migrated lumbar disc is difficult to remove sufficiently by posterolateral endoscopic lumbar dscectomy using a rigid endoscope. However, a satisfactory result can be obtained by applying a transforaminal suprapedicular approach with a flexible semi-rigid curved probe.

Kim, Hyeun Sung; Kim, Seok Won; Kim, Jong Gue

2009-01-01

76

Effects of two types of chairs on stature change and comfort for individuals with healthy and herniated discs  

Microsoft Academic Search

The objective of this study was to determine if stature change and perceived comfort are significantly different for individuals with either healthy or herniated discs when seated in a conventional chair or a sit-stand chair. Sixteen subjects were studied (5 young\\/healthy, 6 old\\/healthy, 5 old\\/herniated). Subjects performed a search task on a computer screen during two 2 h sessions for

DOMINIQUE P. MICHEL; MARTIN G. HELANDER

1994-01-01

77

Use of CT-guided periradicular injection for the treatment of foraminal and extraforaminal disc herniations.  

PubMed

Study design: ?Retrospective case series. Evidence level IV. Objectives: ?To evaluate surgical candidates with foraminal or extraforaminal lumbar disc herniation treated with CT-guided periradicular injection (CTGPI) as a valid treatment option for avoiding surgery. Methods: ?We carried out a retrospective evaluation of 46 consecutive patients with foraminal or extraforaminal disc herniation treated with CTGPI. CTGPI was performed only when radicular pain could not be controlled, or in patients who continued requiring pain medication following an acute episode and whose radicular pain precluded them from resuming their daily activities. Forty-six patients with a minimum 2-year follow-up met the inclusion criteria. There were 21 women and 25 men, with a mean age of 47 years. Results: ?At 1 month after injection, 41 (89%) patients experienced a decrease in radicular pain; 3 experienced no change; and 2 had received surgical treatment. At the final follow-up visit (mean, 74 months) 6 additional patients underwent surgery while 38 (83%) did not require surgery. Pain level comparison between pre-injection and last examination showed that low back pain had decreased a mean of 5 points and radicular pain diminished a mean of 7 points. Twenty-two (58%) of the 38 nonoperated patients had no pain at all and 35 patients had resumed their normal daily activities. No complications were recorded. Conclusion: ?Based on these results, we consider that the use of CTGPI is a reliable alternative before surgery for patients with foraminal or extraforaminal disc herniation without severe motor deficit but with intractable radicular pain. [Table: see text]. PMID:23532378

Gruenberg, Marcelo F; Petracchi, Matías; Valacco, Marcelo; Solá, Carlos

2011-08-01

78

Transforaminal endoscopic surgery for symptomatic lumbar disc herniations: a systematic review of the literature  

PubMed Central

The study design includes a systematic literature review. The objective of the study was to evaluate the effectiveness of transforaminal endoscopic surgery and to compare this with open microdiscectomy in patients with symptomatic lumbar disc herniations. Transforaminal endoscopic techniques for patients with symptomatic lumbar disc herniations have become increasingly popular. The literature has not yet been systematically reviewed. A comprehensive systematic literature search of the MEDLINE and EMBASE databases was performed up to May 2008. Two reviewers independently checked all retrieved titles and abstracts and relevant full text articles for inclusion criteria. Included articles were assessed for quality and outcomes were extracted by the two reviewers independently. One randomized controlled trial, 7 non-randomized controlled trials and 31 observational studies were identified. Studies were heterogeneous regarding patient selection, indications, operation techniques, follow-up period and outcome measures and the methodological quality of these studies was poor. The eight trials did not find any statistically significant differences in leg pain reduction between the transforaminal endoscopic surgery group (89%) and the open microdiscectomy group (87%); overall improvement (84 vs. 78%), re-operation rate (6.8 vs. 4.7%) and complication rate (1.5 vs. 1%), respectively. In conclusion, current evidence on the effectiveness of transforaminal endoscopic surgery is poor and does not provide valid information to either support or refute using this type of surgery in patients with symptomatic lumbar disc herniations. High-quality randomized controlled trials with sufficiently large sample sizes are direly needed to evaluate if transforaminal endoscopic surgery is more effective than open microdiscectomy.

Nellensteijn, Jorm; Bartels, Ronald; Peul, Wilco; van Royen, Barend; van Tulder, Maurits

2009-01-01

79

Postfixed brachial plexus radiculopathy due to thoracic disc herniation in a collegiate wrestler: a case report.  

PubMed

Objective: To present the unique case of a collegiate wrestler with C7 neurologic symptoms due to T1-T2 disc herniation. Background: A 23-year-old male collegiate wrestler injured his neck in a wrestling tournament match and experienced pain, weakness, and numbness in his left upper extremity. He completed that match and 1 additional match that day with mild symptoms. Evaluation by a certified athletic trainer 6 days postinjury showed radiculopathy in the C7 distribution of his left upper extremity. He was evaluated further by the team physician, a primary care physician, and a neurosurgeon. Differential Diagnosis: Cervical spine injury, stinger/burner, peripheral nerve injury, spinal cord injury, thoracic outlet syndrome, brachial plexus radiculopathy. Treatment: The patient initially underwent nonoperative management with ice, heat, massage, electrical stimulation, shortwave diathermy, and nonsteroidal anti-inflammatory drugs without symptom resolution. Cervical spine radiographs were negative for bony pathologic conditions. Magnetic resonance imaging showed evidence of T1-T2 disc herniation. The patient underwent surgery to resolve the symptoms and enable him to participate for the remainder of the wrestling season. Uniqueness: Whereas brachial plexus radiculopathy commonly is seen in collision sports, a postfixed brachial plexus in which the T2 nerve root has substantial contribution to the innervation of the upper extremity is a rare anatomic variation with which many health care providers are unfamiliar. Conclusions: The injury sustained by the wrestler appeared to be C7 radiculopathy due to a brachial plexus traction injury. However, it ultimately was diagnosed as radiculopathy due to a T1-T2 thoracic intervertebral disc herniation causing impingement of a postfixed brachial plexus and required surgical intervention. Athletic trainers and physicians need to be aware of the anatomic variations of the brachial plexus when evaluating and caring for patients with suspected brachial plexus radiculopathies. PMID:23952042

Kuzma, Scott A; Doberstein, Scott T; Rushlow, David R

2013-08-16

80

Surgical treatment of recurrent lumbar disc herniation by transforaminal lumbar interbody fusion  

Microsoft Academic Search

Between 2001 and 2005, 43 patients (average age 54.2, range 36–68 years) with recurrent lumbar disc herniation underwent reoperation\\u000a with the transforaminal lumbar interbody fusion (TLIF) technique at our unit. All cases were followed up for 24–72 months\\u000a (mean 45 months) and graded using the Japanese Orthopaedic Association (JOA) score system pre- and post-operation and during\\u000a the follow-up period. The leg pain of

Zhiming Chen; Jie Zhao; AiGang Liu; Jiandong Yuan; Zhonghai Li

2009-01-01

81

[Use of glucocorticoids in low back pain due to disc herniation with radicular involvement].  

PubMed

Although systemic glucocorticoids are frequently used for the treatment of radicular pain due to disc herniation, there are only few studies available. No trial has successfully demonstrated the superiority of systemic glucocorticoids compared to placebo. Therefore their use is not recommended. Spinal injection using radiographic guidance appears to provide some beneficial short-term effect on pain. It might be offered when pain treatments according to the WHO steps have failed. Because rare but serious adverse events have been reported, transforaminal periradicular injections should only be used after thorough analysis of risks and benefits with the patient. PMID:22073701

Lazarou, Ilias; Genevay, Stéphane; Nendaz, Mathieu

2011-10-19

82

Health-related quality of life in patients with surgically treated lumbar disc herniation  

PubMed Central

Background and purpose Health-related quality of life (HRQoL) instruments have been of increasing interest for evaluation of medical treatments over the past 10–15 years. In this prospective, long-term follow-up study we investigated the influence of preoperative factors and the change in HRQoL over time after lumbar disc herniation surgery. Methods 117 patients surgically treated for lumbar disc herniation (L4-L5 or L5-S1) were evaluated with a self-completion HRQoL instrument (EQ-5D) preoperatively, after 2 years (96 patients) and after 7 years (89 patients). Baseline data (age, sex, duration of leg pain, surgical level) and degree of leg and back pain (VAS) were obtained preoperatively. The mean age was 39 (18–66) years, 54% were men, and the surgical level was L5-S1 in 58% of the patients. The change in EQ-5D score at the 2-year follow-up was analyzed by testing for correlation and by using a multiple regression model including all baseline factors (age, sex, duration of pain, degree of leg and back pain, and baseline EQ-5D score) as potential predictors. Results 85% of the patients reported improvement in EQ-5D two years after surgery and this result remained at the long-term follow-up. The mean difference (change) between the preoperative EQ-5D score and the 2-year and 7-year scores was 0.59 (p < 0.001) and 0.62 (p < 0.001), respectively. However, the HRQoL for this patient group did not reach the mean level of previously reported values for a normal population of the same age range at any of the follow-ups. The changes in EQ-5D score between the 2- and 7-year follow-ups were not statistically significant (mean change 0.03, p = 0.2). There was a correlation between baseline leg pain and the change in EQ-5D at the 2-year (r = 0.33, p = 0.002) and 7-year follow-up (r = 0.23, p = 0.04). However, when using regression analysis the only statistically significant predictor for change in EQ-5D was baseline EQ-5D score. Interpretation Our findings suggest that HRQoL (as measured by EQ-5D) improved 2 years after lumbar disc herniation surgery, but there was no further improvement after 5 more years. Low quality of life and severe leg pain at baseline are important predictors of improvement in quality of life after lumbar disc herniation surgery.

2011-01-01

83

A Novel Approach to the Surgical Treatment of Lumbar Disc Herniations: Indications of Simple Discectomy and Posterior Transpedicular Dynamic Stabilization Based on Carragee Classification  

PubMed Central

Surgery of lumbar disc herniation is still a problem since Mixter and Barr. Main trouble is dissatisfaction after the operation. Today there is a debate on surgical or conservative treatment despite spending great effort to provide patients with satisfaction. The main problem is segmental instability, and the minimally invasive approach via microscope or endoscope is not necessarily appropriate solution for all cases. Microsurgery or endoscopy would be appropriate for the treatment of Carragee type I and type III herniations. On the other hand in Carragee type II and type IV herniations that are prone to develop recurrent disc herniation and segmental instability, the minimal invasive techniques might be insufficient to achieve satisfactory results. The posterior transpedicular dynamic stabilization method might be a good solution to prevent or diminish the recurrent disc herniation and development of segmental instability. In this study we present our experience in the surgical treatment of disc herniations.

Ozer, A. F.; Keskin, F.; Oktenoglu, T.; Suzer, T.; Ataker, Y.; Gomleksiz, C.; Sasani, M.

2013-01-01

84

Surgical Excision of the Lumbar Disc Herniation in Elementary School Age  

PubMed Central

Study Design A retrospective study. Purpose To assess the radiological, clinical features and surgical outcomes of six patients of elementary school age with lumbar disc herniation (LDH). Overview of Literature LDH is common in people in their fourth and fifth decades. However, the condition is extremely rare in children of elementary school age. Moreover, the clinical symptoms and treatments are different from those of adults. Methods We reviewed a series of 6 patients under the age of 12 years, who underwent surgery for LDH at our institution between 1992-2002. Initially, all patients were treated conservatively. The indications for surgery were failure of conservative treatment for 3 months, intractable pain and/or progressive neurological impairment. Results The surgical findings revealed a protruding disc in five cases and a ruptured disc in one. In addition, separation of the vertebral ring apophysis was observed in 3 cases. The symptoms had disappeared completely at the last follow-up. At the last follow-up, the Japanese Orthopaedic Association score was 10 points in 5 cases and 9 points in 1, and the Kirkaldy-Willis criteria was excellent in all patients. No intervertebral disc space narrowing was observed in any patient at last follow up. In addition, there were no degenerative changes in the vertebral endplate and facet joint. Conclusions Patients with symptoms that persist for more than 3 months or those with a progressive neurological deficit must be considered for surgical discectomy.

Kim, Youn-Soo; Park, Il-Jung; Rhyu, Kee-Won; Lee, Sang-Uk

2009-01-01

85

Herniated Disc  

MedlinePLUS

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86

Minimally invasive surgical procedures for the treatment of lumbar disc herniation  

PubMed Central

Introduction In up to 30% of patients undergoing lumbar disc surgery for herniated or protruded discs outcomes are judged unfavourable. Over the last decades this problem has stimulated the development of a number of minimally-invasive operative procedures. The aim is to relieve pressure from compromised nerve roots by mechanically removing, dissolving or evaporating disc material while leaving bony structures and surrounding tissues as intact as possible. In Germany, there is hardly any utilisation data for these new procedures – data files from the statutory health insurances demonstrate that about 5% of all lumbar disc surgeries are performed using minimally-invasive techniques. Their real proportion is thought to be much higher because many procedures are offered by private hospitals and surgeries and are paid by private health insurers or patients themselves. So far no comprehensive assessment comparing efficacy, safety, effectiveness and cost-effectiveness of minimally-invasive lumbar disc surgery to standard procedures (microdiscectomy, open discectomy) which could serve as a basis for coverage decisions, has been published in Germany. Objective Against this background the aim of the following assessment is: Based on published scientific literature assess safety, efficacy and effectiveness of minimally-invasive lumbar disc surgery compared to standard procedures. To identify and critically appraise studies comparing costs and cost-effectiveness of minimally-invasive procedures to that of standard procedures. If necessary identify research and evaluation needs and point out regulative needs within the German health care system. The assessment focusses on procedures that are used in elective lumbar disc surgery as alternative treatment options to microdiscectomy or open discectomy. Chemonucleolysis, percutaneous manual discectomy, automated percutaneous lumbar discectomy, laserdiscectomy and endoscopic procedures accessing the disc by a posterolateral or posterior approach are included. Methods In order to assess safety, efficacy and effectiveness of minimally-invasive procedures as well as their economic implications systematic reviews of the literature are performed. A comprehensive search strategy is composed to search 23 electronic databases, among them MEDLINE, EMBASE and the Cochrane Library. Methodological quality of systematic reviews, HTA reports and primary research is assessed using checklists of the German Scientific Working Group for Health Technology Assessment. Quality and transparency of cost analyses are documented using the quality and transparency catalogues of the working group. Study results are summarised in a qualitative manner. Due to the limited number and the low methodological quality of the studies it is not possible to conduct metaanalyses. In addition to the results of controlled trials results of recent case series are introduced and discussed. Results The evidence-base to assess safety, efficacy and effectiveness of minimally-invasive lumbar disc surgery procedures is rather limited: Percutaneous manual discectomy: Six case series (four after 1998) Automated percutaneous lumbar discectomy: Two RCT (one discontinued), twelve case series (one after 1998) Chemonucleolysis: Five RCT, five non-randomised controlled trials, eleven case series Percutaneous laserdiscectomy: One non-randomised controlled trial, 13 case series (eight after 1998) Endoscopic procedures: Three RCT, 21 case series (17 after 1998) There are two economic analyses each retrieved for chemonucleolysis and automated percutaneous discectomy as well as one cost-minimisation analysis comparing costs of an endoscopic procedure to costs for open discectomy. Among all minimally-invasive procedures chemonucleolysis is the only of which efficacy may be judged on the basis of results from high quality randomised controlled trials (RCT). Study results suggest that the procedure maybe (cost)effectively used as an intermediate therapeutical option between conservative and operative management of small lumbar disc herniations

Luhmann, Dagmar; Burkhardt-Hammer, Tatjana; Borowski, Cathleen; Raspe, Heiner

2005-01-01

87

Full-endoscopic anterior decompression versus conventional anterior decompression and fusion in cervical disc herniations  

PubMed Central

Anterior cervical decompression and fusion (ACDF) is the standard for cervical discectomies. With the full-endoscopic anterior cervical discectomy (FACD) a minimally invasive procedure is available. The objective of this prospective, randomised, controlled study was to compare the results of FACD with those of ACDF in mediolateral soft disc herniations. A total of 103 patients with ACDF or FACD were followed up for two years. In addition to general parameters specific measuring instruments were used. Postoperatively 85.9% of the patients no longer had arm pain, and 10.1% had occasional pain. There were no significant clinical differences between the decompression with or without fusion. The full-endoscopic technique afforded advantages in operation technique, rehabilitation and soft tissue injury. The recorded results show that FACD is a sufficient and safe alternative to conventional procedures when the indication criteria are fulfilled. At the same time, it offers the advantages of a minimally invasive intervention.

Komp, Martin; Merk, Harry; Godolias, Georgios

2008-01-01

88

Psoas compartment blockade in a laterally herniated disc compressing the psoas muscle -a case report-.  

PubMed

A psoas compartment block has been used to provide anesthesia for orthopedic surgical procedures and analgesia for post-operative pain. Currently, this block is advocated for relieving pain in the lower extremity and pelvic area resulting from various origins. We report a case of a 69-year-old male patient who had gait abnormality with posterior pelvic and hip pain, which were both aggravated by hip extension. From the magnetic resonance image, the patient was found to have a laterally herniated intervertebral disc at the L2/3 level, which compressed the right psoas muscle. This was thought to be the origin of the pain, so a psoas compartment block was performed using 0.25% chirocaine with triamcinolone 5mg, and the pain in both the pelvis and hip were relieved. PMID:22514781

Kim, Hye Young; Park, Jin Woo; Park, Soo Young; Moon, Jee Youn; Shin, Jae Hyuck; Park, Sang Hyun

2012-04-04

89

New Diagnostic Tool for Far Lateral Lumbar Disc Herniation : The Clinical Usefulness of 3-Tesla Magnetic Resonance Myelography Comparing with the Discography CT  

PubMed Central

Objective To prospectively assess the diagnostic and clinical value of a new technique (3-tesla magnetic resonance myelography, 3T MRM) as compared to computed tomographic discography (disco-CT) in patients with far lateral disc herniation. Methods We evaluated 3T MRM and disco-CT of 25 patients, whom we suspected of suffering from far lateral disc herniation. Using an assessment scale, 4 observers examined independently both 3T MRM and disco-CT images. We analyzed observer agreement and the accentuation of each image. Results We found complete matching, and observer agreement, between high resolution images of 3T MRM and disco-CT for diagnosing far lateral disc herniation. Conclusion We think noninvasive 3T MRM is an appropriate diagnostic tool for far lateral disc herniation as compared to disco-CT.

Kim, Duk-Gyu; Park, Jung-Soo

2012-01-01

90

Risk factors for back pain-related loss of working time after surgery for lumbar disc herniation: a 5-year follow-up study  

Microsoft Academic Search

The aim of this study is to explore the occurrence and the risk factors of back-related loss of working time in patients undergoing\\u000a surgery for lumbar disc herniation. One hundred and fifty-two gainfully employed patients underwent surgery for lumbar disc\\u000a herniation. Two months postoperatively, those patients completed a self-report questionnaire including queries on back and\\u000a leg pain (VAS), functional capacity

K. Puolakka; J. Ylinen; M. H. Neva; H. Kautiainen; A. Häkkinen

2008-01-01

91

Clinical outcomes of patients with lumbar disc herniation, selected for one-level open-discectomy and microdiscectomy  

Microsoft Academic Search

The aim of our study was twofold: firstly, to compare the preoperative and postoperative results at mid-term follow-up periods\\u000a along with the data of the control group. Secondly, to evaluate the effectiveness among open-discectomy and microdiscectomy\\u000a surgical groups. In the present study, we investigated a cohort of 100 patients with the lumbar disc herniation causing low\\u000a back pain compared to

Kotryna Veresciagina; Bronius Spakauskas; Kazys Vytautas Ambrozaitis

2010-01-01

92

Single-blind randomised controlled trial of chemonucleolysis and manipulation in the treatment of symptomatic lumbar disc herniation  

Microsoft Academic Search

This single-blind randomised clinical trial compared osteopathic manipulative treatment with chemonucleolysis (used as a\\u000a control of known efficacy) for symptomatic lumbar disc herniation. Forty patients with sciatica due to this diagnosis (confirmed\\u000a by imaging) were treated either by chemonucleolysis or manipulation. Outcomes (leg pain, back pain and self-reported disability)\\u000a were measured at 2 weeks, 6 weeks and 12 months. The

A. Kim Burton; K. Malcolm Tillotson; John Cleary

2000-01-01

93

Prognostic factors for non-success in patients with sciatica and disc herniation  

PubMed Central

Background Few studies have investigated prognostic factors for patients with sciatica, especially for patients treated without surgery. The aim of this study was to identify factors associated with non-success after 1 and 2?years of follow-up and to test the prognostic value of surgical treatment for sciatica. Methods The study was a prospective multicentre observational study including 466 patients with sciatica and lumbar disc herniation. Potential prognostic factors were sociodemographic characteristics, back pain history, kinesiophobia, emotional distress, pain, comorbidity and clinical examination findings. Study participation did not alter treatment considerations for the patients in the clinics. Patients reported on the questionnaires if surgery of the disc herniation had been performed. Uni- and multivariate logistic regression analyses were used to evaluate factors associated with non-success, defined as Maine–Seattle Back Questionnaire score of ?5 (0–12) (primary outcome) and Sciatica Bothersomeness Index ?7 (0–24) (secondary outcome). Results Rates of non-success were at 1 and 2?years 44% and 39% for the main outcome and 47% and 42% for the secondary outcome. Approximately 1/3 of the patients were treated surgically. For the main outcome variable, in the final multivariate model non-success at 1?year was significantly associated with being male (OR 1.70 [95% CI; 1.06???2.73]), smoker (2.06 [1.31???3.25]), more back pain (1.0 [1.01???1.02]), more comorbid subjective health complaints (1.09 [1.03???1.15]), reduced tendon reflex (1.62 [1.03???2.56]), and not treated surgically (2.97 [1.75???5.04]). Further, factors significantly associated with non-success at 2?years were duration of back problems?>;?1?year (1.92 [1.11???3.32]), duration of sciatica?>;?3?months (2.30 [1.40???3.80]), more comorbid subjective health complaints (1.10 [1.03???1.17]) and kinesiophobia (1.04 [1.00???1.08]). For the secondary outcome variable, in the final multivariate model, more comorbid subjective health complaints, more back pain, muscular weakness at clinical examination, and not treated surgically, were independent prognostic factors for non-success at both 1 and 2?years. Conclusions The results indicate that the prognosis for sciatica referred to secondary care is not that good and only slightly better after surgery and that comorbidity should be assessed in patients with sciatica. This calls for a broader assessment of patients with sciatica than the traditional clinical assessment in which mainly the physical symptoms and signs are investigated.

2012-01-01

94

Effectiveness of heat-sensitive moxibustion in the treatment of lumbar disc herniation: study protocol for a randomized controlled trial  

PubMed Central

Background Lumbar disc herniation is a common and costly problem. Moxibustion is employed to relieve symptoms and might therefore act as a therapeutic alternative. Many studies have already reported encouraging results in heat-sensitive moxibustion for lumbar disc herniation. Hence, we designed a randomized controlled clinical trial to investigate the effectiveness of heat-sensitive moxibustion compared with conventional moxibustion. Methods This trial is a multicenter, prospective, randomized controlled clinical trial. The 316 eligible patients are randomly allocated to two different groups. The experimental group is treated with heat-sensitive moxibustion (n = 158); while the control group (n = 158) is treated with conventional moxibustion. The moxibustion locations are different for the groups. The experimental group selects heat-sensitization acupoints from the region which consists of bilateral Da Changshu (BL25) and Yao Shu (Du2). Meanwhile, fixed acupoints are used in control group; patients in both groups receive 18 sessions in 2 weeks. Discussion The study design guarantees a high internal validity for the results. It is one large-scale randomized controlled trial to evaluate the efficacy of heat-sensitive moxibustion compared to conventional moxibustion and may provide evidence for this therapy as a treatment for moderate and severe lumbar disc herniation. Moreover, the result may uncover the inherent laws to improve the therapeutic effect with suspended moxibustion. Trial Registration The trial is registered at Chinese Clinical Trials Registry: ChiCTR-TRC-09000604. The application date was 27 November 2009. The first patient was randomized on the 16 June 2011.

2011-01-01

95

A PHASED REHABILITATION PROTOCOL FOR ATHLETES WITH LUMBAR INTERVERTEBRAL DISC HERNIATION  

PubMed Central

Conservative non-surgical management of a herniated lumbar intervertebral disc (HLD) in athletes is a complex task due to the dramatic forces imparted on the spine during sport participation. The demands placed upon the athlete during rehabilitation and return to sport are unique not only from a sport specific perspective, but also regarding return to the sport strength and conditioning programs utilized for sport preparation. Many prescriptions fail to address postural and motor control faults specific to athletic development, which may prevent full return to sport after suffering a HLD or predispose the athlete to future exacerbations of a HLD. Strength exercises involving squatting, deadlifting, and Olympic power lifts are large components of the typical athlete's conditioning program, therefore some progressions are provided to address potential underlying problems in the athlete's technique that may have contributed to their HLD in the first place. The purpose of this clinical commentary is to propose a framework for rehabilitation that is built around the phases of healing of the disc. Phase I: Non-Rotational/Non-Flexion Phase (Acute Inflammatory Phase), Phase II: Counter rotation/Flexion Phase (Repair Phase), Phase III: Rotational Phase/Power development (Remodeling Phase), and Phase IV: Full return to sport. This clinical commentary provides a theoretical basis for these phases based on available literature as well as reviewing many popular current practice trends in the management of an HLD. The authors recognize the limits of any general exercise rehabilitation recommendation with regard to return to sport, as well as any general strength and conditioning program. It is vital that an individual assessment and prescription is made for every athlete which reviews and addresses movement in all planes of motion under all necessary extrinsic and intrinsic demands to that athlete. Level of Evidence: 5

VanGelder, Leonard H.; Vaughn, Daniel W.

2013-01-01

96

Trend of the incidence of lumbar disc herniation: decreasing with aging in the elderly  

PubMed Central

Background Compelling evidence has shown that the incidence of lumbar disc herniation (LDH) increases with age. In this study, retrospective clinical analysis of 601 cases of LDH has been conducted to investigate the role of age in the incidence of LDH in the elderly. The aim of the study is to investigate the relationship between the process of aging and the occurrence of LDH in old adults. Methods Clinical cases (n = 601) of LDH were retrospectively analyzed. Results The imaging examination with computed tomography and/or magnetic resonance imaging showed the occurrence of degeneration in LDH patients over 65 years of age. The most common site of LDH is toward the bottom of the spine at L4–L5 and/or L5–S1. The incidence of LDH drops with age in the elderly, especially after the age of 80 years. There is an obvious decrease in LDH in the elderly female. Conclusion A decreasing incidence of LDH with aging occurs in the elderly. This investigation indicates that aging is not a contributor to the performance of LDH in the elderly although the incidence of LDH is proportional to age.

Ma, Daoyou; Liang, Yunbiao; Wang, Daoming; Liu, Zejiang; Zhang, Wei; Ma, Tantan; Zhang, Liang; Lu, Xingjun; Cai, Zhiyou

2013-01-01

97

Military Rank and the Symptoms of Lumbar Disc Herniation in Young Korean Soldiers.  

PubMed

OBJECTIVE: There are many factors associated with the symptom presentation of lumbar disc herniation (LDH). However, there are only few reports regarding the clinical feature of LDH in military medicine. The objective of this study is to determine the factors that affected the symptoms of LDH in young Korean soldiers. METHODS: One hundred thirty male soldiers, diagnosed with LDH, were enrolled in this study. They were divided into four groups, according to their military ranks: private, private first class, corporal, and sergeant. The visual analog scale for low back pain (VAS-LBP), the VAS for leg pain (VAS-LP), and the Oswestry Disability Index (ODI) were evaluated. The education level and military rank were also reviewed and their relationship with the degree of symptoms was investigated. RESULTS: The mean age for the male subjects enrolled was 20.7 ± 1.2. The mean VAS-LBP, VAS-LP, and ODI were 6.6% ± 1.7%, 7.1% ± 1.9%, and 46.0% ± 16.3%, respectively. There was no statistically significant relationship between the degree of symptoms and the radiologic findings. However, the military rank had an inverse correlation with the VAS scores and the ODI (P < 0.05). CONCLUSION: Our data showed that the military rank was associated with the symptom presentation of LDH and reflected the characteristics of military life. PMID:23428375

Kang, Suk Hyung; Yang, Jin Seo; Cho, Yong Jun; Park, Seung Won; Ko, Kwang Pil

2013-02-18

98

[Spontaneous regression of lumbar and cervical disc herniations - a well established phenomenon].  

PubMed

Symptomatic lumbar (LDH) and cervical disc herniations (CDH) are highly prevalent diseases that neurosurgeons and orthopaedic surgeons face every day. If symptom control cannot be achieved by nonsurgical means or in cases with severe or progressive neurological deficits, a surgical therapy is generally recommended. Nevertheless, the majority of patients will improve significantly or even completely without surgery over weeks until months after symptom onset. Still, when a recommendation is to be made concerning the further treatment in affected patients, it has to be kept in mind that the nonsurgical therapy may be associated with disabling pain and persisting neurological deficits with influence on the functional capacity, quality of life and ability to work for a variable period. Today, it is almost impossible to predict which patient will profit from nonsurgical therapy and which patient will require surgery during the clinical course because of incomplete alleviation. In this work, we present two current cases of patients with spontaneous regression of a LDH and a CDH. PMID:23692907

Gautschi, Oliver P; Stienen, Martin N; Schaller, Karl

2013-05-22

99

A retrospective study of intervertebral disc herniation in dogs in Japan: 297 cases.  

PubMed

We investigated the epidemiological characteristics of intervertebral disc herniation (IVDH) in Japan in a large population using a retrospective study. The sample population was dogs (n=297) with IVDH in Japan. Medical records were reviewed for breed, sex, age, affected interspace and neurological severity. The dogs were comprised of 132 cases of cervical IVDH (C-IVDH) and 165 cases of thoracolumbar IVDH (TL-IVDH). In Japan, the Dachshund, Beagle and Shih Tzu tended to suffer from both C-IVDH and TL-IVDH. The Shiba Inu, a characteristic Japanese dog breed, suffered from both C-IVDH and TL-IVDH, although there was little data relating to the whole breed. Male dogs tended to suffer from C-IVDH and TL-IVDH at a rate almost twice that of females in Japan. Among the three predominant dog breeds, the Dachshund, Beagle and Shih Tzu, the Dachshund tended to suffer from both C-IVDH and TL-IVDH at an earlier age than the Beagle, and the Beagle tended to suffer from both C-IVDH and TL-IVDH earlier than the Shih Tzu. Among the three predominant breeds, the Shih Tzu, in particular, tended to suffer from both C-IVDH and TL-IVDH at multiple sites. Our data from Japan were in partial agreement with previous data from the U.S.A., and epidemiological characteristics of IVDH peculiar to Japan were also identified. PMID:18685242

Itoh, Hisanori; Hara, Yasushi; Yoshimi, Natsuko; Harada, Yasuji; Nezu, Yoshinori; Yogo, Takuya; Ochi, Hiroki; Hasegawa, Daisuke; Orima, Hiromitsu; Tagawa, Masahiro

2008-07-01

100

Combined intra-extracanal approach to lumbosacral disc herniations with bi-radicular involvement. Technical considerations from a surgical series of 15 cases.  

PubMed

Large lumbosacral disc herniations effacing both the paramedian and the foraminal area often cause double radicular compression. Surgical management of these lesions may be difficult. A traditional interlaminar approach usually brings into view only the paramedian portion of the intervertebral disc, unless the lateral bone removal is considerably increased. Conversely, the numerous far-lateral approaches proposed for removing foraminal or extraforaminal disc herniations would decompress the exiting nerve root only. Overall, these approaches share the drawback of controlling the neuroforamen on one side alone. A combined intra-extraforaminal exposure is a useful yet rarely reported approach. Over a 3-year period, 15 patients with bi-radicular symptoms due to large disc herniations of the lumbar spine underwent surgery through a combined intra-extracanal approach. A standard medial exposure with an almost complete hemilaminectomy of the upper vertebra was combined with an extraforaminal exposure, achieved by minimal drilling of the inferior facet joint, the lateral border of the pars interarticularis and the inferior margin of the superior transverse process. The herniated discs were removed using key maneuvers made feasible by working simultaneously on both operative windows. In all cases the disc herniation could be completely removed, thus decompressing both nerve roots. Radicular pain was fully relieved without procedure-related morbidity. The intra-extraforaminal exposure was particularly useful in identifying the extraforaminal nerve root early. Early identification was especially advantageous when periradicular scar tissue hid the nerve root from view, as it did in patients who had undergone previous surgery at the same site or had long-standing radicular symptoms. Controlling the foramen on both sides also reduced the risk of leaving residual disc fragments. A curved probe was used to push the disc material outside the foramen. In conclusion, specific surgical maneuvers made feasible by a simultaneous extraspinal and intraspinal exposure allow quick, safe and complete removal of lumbosacral disc herniations with paramedian and foraminal extension. PMID:15761707

Paolini, Sergio; Ciappetta, Pasquale; Raco, Antonino; Missori, Paolo; Delfini, Roberto

2005-03-11

101

Treating thoracic-disc herniations: Do we always have to go anteriorly?  

PubMed

Study design: ?Retrospective cohort study. Objective: ?To determine if there is a difference in outcome and complications in surgically managed patients with thoracic-disc herniations (TDH) undergoing a modified transfacet pedicle-sparing decompression and fusion (posteriorly) compared to those undergoing anterior transthoracic discectomies (anteriorly). Methods: ?Thirty-five consecutive operatively managed TDH underwent operative management between March 2003 and November 2009. Outcomes and complications were reviewed from patient records and x-rays assessing differences between those treated posteriorly and those treated anteriorly. Results: ?Twenty-four patients underwent posterior management for 35 TDH and ten patients underwent anterior management for twelve TDH. Mean age was 50 years in both groups. Body mass index (BMI) averaged 28.8 in the anterior group and 32.0 in the posterior group. Follow-up averaged 38 weeks with four patients lost to follow-up (all posterior). Major complications secondary to surgery occurred in three patients (30%) in the anterior group (pulmonary embolus, pneumonia, and wrong level surgery) and in seven patients (35%) in the posterior group (seroma, misplaced instrumentation requiring revision, recurrence requiring an additional operation, and four infections). No neurological complications occurred and all patients noted improvement from baseline. Average length of stay was 7.3 days in the anterior group and 4.2 days in the posterior group (P < .003). Final pain as assessed by visual analog scale (VAS) improved from 6.7 to 4.3 in the anterior group and 6.9 to 2.3 in the posterior group (P?=?.05). Conclusions: ?Complication rates are similar between groups and are approach related. Posteriorly managed patients had greater improvement in pain and shorter length of stay. [Table: see text] The definition of the different classes of evidence is available on page 83. PMID:23544020

Bransford, Richard J; Zhang, Fangyi; Bellabarba, Carlo; Lee, Michael J

2010-05-01

102

Fluoroscopic caudal epidural injections in managing chronic axial low back pain without disc herniation, radiculitis, or facet joint pain  

PubMed Central

Background Chronic low back pain without disc herniation is common. Various modalities of treatments are utilized in managing this condition, including epidural injections. However, there is continued debate on the effectiveness, indications, and medical necessity of any treatment modality utilized for managing axial or discogenic pain, including epidural injections. Methods A randomized, double-blind, actively controlled trial was conducted. The objective was to evaluate the ability to assess the effectiveness of caudal epidural injections of local anesthetic with or without steroids for managing chronic low back pain not caused by disc herniation, radiculitis, facet joints, or sacroiliac joints. A total of 120 patients were randomized to two groups; one group did not receive steroids (group 1) and the other group did (group 2). There were 60 patients in each group. The primary outcome measure was at least 50% improvement in Numeric Rating Scale and Oswestry Disability Index. Secondary outcome measures were employment status and opioid intake. These measures were assessed at 3, 6, 12, 18, and 24 months after treatment. Results Significant pain relief and functional status improvement (primary outcome) defined as a 50% or more reduction in scores from baseline, were observed in 54% of patients in group 1 and 60% of patients in group 2 at 24 months. In contrast, 84% of patients in group 1 and 73% in group 2 saw significant pain relief and functional status improvement in the successful groups at 24 months. Conclusion Caudal epidural injections of local anesthetic with or without steroids are effective in patients with chronic axial low back pain of discogenic origin without facet joint pain, disc herniation, and/or radiculitis.

Manchikanti, Laxmaiah; Cash, Kimberly A; McManus, Carla D; Pampati, Vidyasagar

2012-01-01

103

Translaminar Microendoscopic Herniotomy for Cranially Migrated Lumbar Disc Herniations Encroaching on the Exiting Nerve Root in the Preforaminal and Foraminal Zones  

PubMed Central

Study Design Case series. Purpose The aim of this study was to describe translaminar microendoscopic herniotomy (TL-MEH) for cranially migrated lumbar disc herniations encroaching on the exiting nerve root in the preforaminal and foraminal zones and to report preliminary results of the procedure. Overview of Literature Conventional interlaminar approaches for preforaminal and foraminal lumbar disc herniations result in extensive removal of the lamina and facet joint to remove disc fragments safely. More destructive approaches increase the risk of postoperative segmental instability. Methods TL-MEH is a minimally invasive procedure for herniotomy via the translaminar approach using a microendoscopic technique. TL-MEH was performed in seven patients with a cranially migrated lumbar disc herniation encroaching on the exiting nerve root. The disc fragments were located in the preforaminal zone in four patients, and in the preforaminal and foraminal zones in three. Results All patients experienced immediate relief from symptoms after surgery and satisfactory results at the final follow-up. Surgical complications, such as a dural tear, nerve injury, and surgical site infection, were not investigated. Conclusions TL-MEH seemed to be an effective and safe alternative minimally invasive surgical option for patients with a cranially migrated lumbar disc herniation encroaching the exiting nerve root in the preforaminal and foraminal zones.

Tono, Osamu; Senba, Hideyuki; Kitamura, Takahiro; Komiya, Norihiro; Oga, Masayoshi; Shidahara, Satoshi

2013-01-01

104

Herniated L4-L5 disc after placement of Harrington instrumentation for a fracture of the thoracolumbar spine.  

PubMed

The authors report a case in which L5 radiculopathy developed acutely after surgery for placement of Harrington rod instrumentation for an L1 body fracture. Computed tomographic myelography demonstrated a large L4-L5 herniated disc that had not been present in preoperative studies. An emergency laminectomy was performed, and a large, free, subligamentous disc fragment was removed. The patient subsequently regained L5 sensorimotor function. The postoperative development of lumbar radiculopathy is an uncommon complication of Harrington rod instrumentation that may result from several biomechanical features of the instrumentation. These injuries may not be detected by intraoperative monitoring of somatosensory evoked potentials, and therefore, the postoperative neurological examination assumes a crucial role in the early diagnosis of these lesions. As our case demonstrates, these radicular deficits may be reversible if their cause is promptly recognized and treated. PMID:1870676

Segal, R; Pollack, I; Segal, E; Hanley, E; Scalbassi, R; Hirsch, W

1991-07-01

105

Treating thoracic-disc herniations: Do we always have to go anteriorly?  

PubMed Central

Study design:?Retrospective cohort study. Objective:?To determine if there is a difference in outcome and complications in surgically managed patients with thoracic-disc herniations (TDH) undergoing a modified transfacet pedicle-sparing decompression and fusion (posteriorly) compared to those undergoing anterior transthoracic discectomies (anteriorly). Methods:?Thirty-five consecutive operatively managed TDH underwent operative management between March 2003 and November 2009. Outcomes and complications were reviewed from patient records and x-rays assessing differences between those treated posteriorly and those treated anteriorly. Results:?Twenty-four patients underwent posterior management for 35 TDH and ten patients underwent anterior management for twelve TDH. Mean age was 50 years in both groups. Body mass index (BMI) averaged 28.8 in the anterior group and 32.0 in the posterior group. Follow-up averaged 38 weeks with four patients lost to follow-up (all posterior). Major complications secondary to surgery occurred in three patients (30%) in the anterior group (pulmonary embolus, pneumonia, and wrong level surgery) and in seven patients (35%) in the posterior group (seroma, misplaced instrumentation requiring revision, recurrence requiring an additional operation, and four infections). No neurological complications occurred and all patients noted improvement from baseline. Average length of stay was 7.3 days in the anterior group and 4.2 days in the posterior group (P < .003). Final pain as assessed by visual analog scale (VAS) improved from 6.7 to 4.3 in the anterior group and 6.9 to 2.3 in the posterior group (P?=?.05). Conclusions:?Complication rates are similar between groups and are approach related. Posteriorly managed patients had greater improvement in pain and shorter length of stay. Methods evaluation and class of evidence (CoE) Methodological principle: Study design:  Randomized controlled trial  Cohort study •  Case control  Case series Statement of concealed allocation* Intent to treat* Independent or blind assessment • Complete follow-up of ?85% Adequate sample size Controlling for possible confounding Evidence class: III *Applies to randomized controlled trials only. The definition of the different classes of evidence is available on page 83.

Bransford, Richard J.; Zhang, Fangyi; Bellabarba, Carlo; Lee, Michael J.

2010-01-01

106

Fluoroscopic cervical epidural injections in chronic axial or disc-related neck pain without disc herniation, facet joint pain, or radiculitis  

PubMed Central

Background While chronic neck pain is a common problem in the adult population, with a typical 12-month prevalence of 30%–50%, there is a lack of consensus regarding its causes and treatment. Despite limited evidence, cervical epidural injections are one of the commonly performed nonsurgical interventions in the management of chronic neck pain. Methods A randomized, double-blind, active, controlled trial was conducted to evaluate the effectiveness of cervical interlaminar epidural injections of local anesthetic with or without steroids for the management of chronic neck pain with or without upper extremity pain in patients without disc herniation, radiculitis, or facet joint pain. Results One hundred and twenty patients without disc herniation or radiculitis and negative for facet joint pain by means of controlled diagnostic medial branch blocks were randomly assigned to one of two treatment groups, ie, injection of local anesthetic only (group 1) or local anesthetic mixed with nonparticulate betamethasone (group 2). The primary outcome of significant pain relief and improvement in functional status (?50%) was demonstrated in 72% of group 1 and 68% of group 2. The overall average number of procedures per year was 3.6 in both groups with an average total relief per year of 37–39 weeks in the successful group over a period of 52 weeks. Conclusion Cervical interlaminar epidural injections of local anesthetic with or without steroids may be effective in patients with chronic function-limiting discogenic or axial pain.

Manchikanti, Laxmaiah; Cash, Kimberly A; Pampati, Vidyasagar; Malla, Yogesh

2012-01-01

107

The NEtherlands Cervical Kinematics (NECK) Trial. Cost-effectiveness of anterior cervical discectomy with or without interbody fusion and arthroplasty in the treatment of cervical disc herniation; a double-blind randomised multicenter study  

Microsoft Academic Search

BACKGROUND: Patients with cervical radicular syndrome due to disc herniation refractory to conservative treatment are offered surgical treatment. Anterior cervical discectomy is the standard procedure, often in combination with interbody fusion. Accelerated adjacent disc degeneration is a known entity on the long term. Recently, cervical disc prostheses are developed to maintain motion and possibly reduce the incidence of adjacent disc

Mark P Arts; Ronald Brand; Elske van den Akker; Bart W Koes; Wilco C Peul

2010-01-01

108

Cost-effectiveness of microendoscopic discectomy versus conventional open discectomy in the treatment of lumbar disc herniation: a prospective randomised controlled trial [ISRCTN51857546  

Microsoft Academic Search

BACKGROUND: Open discectomy is the standard surgical procedure in the treatment of patients with long-lasting sciatica caused by lumbar disc herniation. Minimally invasive approaches such as microendoscopic discectomy have gained attention in recent years. Reduced tissue trauma allows early ambulation, short hospital stay and quick resumption of daily activities. A comparative cost-effectiveness study has not been performed yet. We present

Mark P Arts; Wilco C Peul; Ronald Brand; Bart W Koes; Ralph TWM Thomeer

2006-01-01

109

Outcomes of a prospective cohort study on peri-radicular infiltration for radicular pain in patients with lumbar disc herniation and spinal stenosis  

Microsoft Academic Search

The purpose of this study was to assess the outcome of peri-radicular infiltration for radicular pain in patients with spinal stenosis and lumbar disc herniation (LDH). Patients with spinal stenosis ( n=62) or LDH ( n=55) who met our criteria received fluoroscopically guided peri-radicular infiltration of local anaesthetic and steroid at the site of documented pathology. All the patients were

Leslie Chong Lich Ng; Philip Sell

2004-01-01

110

Matrix metalloprotease-9 activity in the cerebrospinal fluid and spinal injury severity in dogs with intervertebral disc herniation.  

PubMed

We investigated whether matrix metalloproteinase (MMP)-9 expression in the cerebrospinal fluid (CSF) of dogs with intervertebral disc herniation (IVDH) is associated with the severity of neurological signs and prognosis. CSF from the cisterna magna (C-CSF) and the lumbar spine (L-CSF) of 34 dogs with IVDH was analyzed using zymography. Activity of MMP-9 in L-CSF was detected in 6 of 34 dogs with IVDH, often for more than 7 days after injury. MMP-9 activity was not detected from any of the C-CSF samples. Of the six cases that were MMP-9 positive, all four cases with grade V that had loss of deep pain were non-ambulatory 6 months after treatment. The remaining two cases with grade III and IV could recover mobility. In dogs with grade V thoracolumbar IVDH, MMP-9 expression in the CSF may indicate severe spinal cord injury with poor prognosis. PMID:20965533

Nagano, S; Kim, S H; Tokunaga, S; Arai, K; Fujiki, M; Misumi, K

2010-10-20

111

Analysis of cartilage oligomeric matrix protein and matrix metalloproteinase-9 in cerebrospinal fluid of miniature dachshund with intervertebral disc herniation.  

PubMed

We evaluated whether the cerebrospinal fluid (CSF) concentration of cartilage oligomeric matrix protein (COMP) is related to disease severity, prognosis and matrix metalloproteinase (MMP)-9 activity of the CSF in miniature dachshund with intervertebral disc herniation. Samples were obtained from 23 patients and 6 normal dogs, and all patients received hemilaminectomy. Twenty dogs recovered successfully and 3 of 11 dogs without deep nociception had MMP-9 activity in the CSF and an unsuccessful outcome. The COMP levels from patients were significantly higher than those from normal dogs. MMP-9 activity and neurological severity were not related to the COMP levels. However, the COMP levels from 3 unsuccessful cases that had MMP-9 activity were significantly lower than those from all recovered cases and/or successful cases without deep nociception. Concerning severe cases, increased proteolytic activity might affect the COMP concentration and prognosis due to MMP-9 associated deleterious effects. PMID:22440362

Nagano, Shinichi; Fujiki, Makoto; Tokunaga, Satoshi; Misumi, Kazuhiro

2012-03-20

112

Matrix metalloproteinase expression levels suggest distinct enzyme roles during lumbar disc herniation and degeneration  

Microsoft Academic Search

The disruption of the extracellular disc matrix is a major hallmark of disc degeneration. This has previously been shown to\\u000a be associated with an up-regulation of major matrix metalloproteinase (MMP) expression and activity. However, until now hardly\\u000a any data are available for MMP\\/TIMP regulation and thereby no concept exists as to which MMP\\/TIMP plays a major role in disc\\u000a degeneration.

Beatrice E. Bachmeier; Andreas Nerlich; Norbert Mittermaier; Christoph Weiler; Christianto Lumenta; Karin Wuertz; Norbert Boos

2009-01-01

113

Higher preoperative Oswestry Disability Index is associated with better surgical outcome in upper lumbar disc herniations  

Microsoft Academic Search

To evaluate the surgical outcome in terms of functional and subjective recovery, patients who needed discectomies at L1–L2,\\u000a L2–L3 and L3–L4 levels were compared with an age and sex-matched group of patients who required L4–L5 and L5–S1 discectomies.\\u000a We prospectively enrolled 50 consecutive patients, referred to our center, who had L1–L2, L2–L3 and L3–L4 herniations and\\u000a required surgical intervention. Likewise,

Hooshang Saberi; Arash Vatankhahan Isfahani

2008-01-01

114

Fragmentectomy versus Conventional Microdiscectomy in Single-Level Lumbar Disc Herniations : Comparison of Clinical Results and Recurrence Rates  

PubMed Central

Objective This retrospective study aimed to compare clinical outcomes in terms of pain relief and recurrence rate between fragmentectomies and conventional microdiscectomies in patients with lumbar disc herniation (LDH). Methods Between January 2008 and May 2011, a total of 175 patients met the inclusion criteria of this study. The visual analogue scale (VAS) scores of back and radicular pains were recorded before surgery, 2 and 6 weeks after surgery. Recurrence was defined when a patient had the same pattern of preoperative symptoms and was confirmed with magnetic resonance imaging. Results Seventy-four patients (42.3%) were suitable for fragmentectomy, and 101 patients underwent conventional microdiscectomy. There were no significant differences in VAS scores between the fragmentectomy and conventional microdiscectomy groups 2 and 6 weeks after surgery. During the follow-up period, 3 patients (4.05%) in the fragmentectomy group and 7 patients (6.93%) in the conventional microdiscectomy group relapsed. Conclusion If patients are selected according to well-defined criteria, fragmentectomy can be a good surgical option for LDH, in the physiological aspect of preserving healthy intervertebral disc materials.

Kim, Yeon-Seong; Lee, Min-Cheol; Song, Jae-Wook; Kim, Sang-Kyu; Kim, In-Hwan

2012-01-01

115

The influence of torsion on disc herniation when combined with flexion  

Microsoft Academic Search

The role of torsion in the mechanical derangement of intervertebral discs remains largely undefined. The current study sought\\u000a to investigate if torsion, when applied in combination with flexion, affects the internal failure mechanics of the disc wall\\u000a when exposed to high nuclear pressure. Thirty ovine lumbar motion segments were each positioned in 2° axial rotation plus\\u000a 7° flexion. Whilst maintained

Samuel P. VeresPeter; Peter A. Robertson; Neil D. Broom

2010-01-01

116

The influence of torsion on disc herniation when combined with flexion  

PubMed Central

The role of torsion in the mechanical derangement of intervertebral discs remains largely undefined. The current study sought to investigate if torsion, when applied in combination with flexion, affects the internal failure mechanics of the disc wall when exposed to high nuclear pressure. Thirty ovine lumbar motion segments were each positioned in 2° axial rotation plus 7° flexion. Whilst maintained in this posture, the nucleus of each segment was gradually injected with a viscous radio-opaque gel, via an injection screw placed longitudinally within the inferior vertebra, until failure occurred. Segments were then inspected using micro-CT and optical microscopy in tandem. Five motion segments failed to pressurize correctly. Of the remaining 25 successfully tested motion segments, 17 suffered vertebral endplate rupture and 8 suffered disc failure. Disc failure occurred in mature motion segments significantly more often than immature segments. The most common mode of disc failure was a central posterior radial tear involving a systematic annulus–endplate–annulus failure pattern. The endplate portion of these radial tears often propagated contralateral to the direction of applied axial rotation, and, at the lateral margin, only those fibres inclined in the direction of the applied torque were affected. Apart from the 2° of applied axial rotation, the methods employed in this study replicated those used in a previously published study. Consequently, the different outcome obtained in this study can be directly attributed to the applied axial rotation. These inter-study differences show that when combined with flexion, torsion markedly reduces the nuclear pressure required to form clinically relevant radial tears that involve cartilaginous endplate failure. Conversely, torsion appears to increase the disc wall’s resistance to radial tears that do not involve cartilaginous endplate failure, effectively halving the disc wall’s overall risk of rupture.

Robertson, Peter A.; Broom, Neil D.

2010-01-01

117

A minimally invasive treatment for lumbar disc herniation: DiscoGel® chemonucleolysis in patients unresponsive to chemonucleolysis with oxygen-ozone.  

PubMed

A multitude of therapies is available to treat disc herniation, ranging from conservative methods (medication and physical therapy) to minimally invasive (percutaneous) treatments and surgery. O?-O? chemonucleolysis (O?-O? therapy) is one of the minimally invasive treatments with the best cost/benefit ratio and lowest complication rate. Another substance recently made available exploiting the chemical properties of pure ethanol is DiscoGel®, a radiopaque gelified ethanol more viscous than absolute alcohol 8,9. The present study aimed to assess the therapeutic outcome of DiscoGel® chemonucleolysis in patients with lumbar disc herniation unresponsive to O?-O? therapy. Thirty-two patients aged between 20 and 79 years were treated by DiscoGel® chemonucleolysis between December 2008 and January 2010. The treatment was successful (improvement in pain) in 24 out of 32 patients. DiscoGel® is safe and easy to handle and there were no complications related to product diffusivity outside the treatment site. The therapeutic success rate of DiscoGel® chemonucleolysis in patients unresponsive to O?-O? therapy was satisfactory. Among other methods used to treat lumbar disc herniation, DiscoGel® chemonucleolysis can be deemed an intermediate procedure bridging conservative medical treatments and surgery. PMID:22440607

Stagni, S; de Santis, F; Cirillo, L; Dall'olio, M; Princiotta, C; Simonetti, L; Stafa, A; Leonardi, M

2012-03-16

118

Spinal nociceptive hyperexcitability induced by experimental disc herniation is associated with enhanced local expression of Csf1 and FasL.  

PubMed

Sciatica after disc herniation may be associated with compression of spinal nerves, but also inflammatory substances released from the nucleus pulposus (NP) leaking into the spinal canal. Here, in an animal model mimicking clinical intervertebral disc herniation, we investigate the effect of NP on neuronal activity. In anaesthetized Lewis rats, extracellular single-unit recordings of spinal dorsal horn neurons were performed, and the C-fibre responses were examined. Moreover, quantitative polymerase chain reaction was used to explore the gene expression of proinflammatory cytokines in the NP tissue exposed to the spinal dorsal nerve roots L3-L5. In accordance with earlier studies, we showed a significant increase in the C-fibre response and an upregulation of the gene expression of interleukin 1? and tumour necrosis factor 180minutes after application of NP onto the nerve roots. Moreover, based on a polymerase chain reaction array of 84 common inflammatory cytokines at the same time point, we demonstrated a highly significant upregulation of colony-stimulating factor 1 also termed macrophage colony-stimulating factor and Fas ligand. The pronounced upregulation of Csf1 and Fas ligand 180minutes after application of NP onto the nerve roots suggests that macrophage activation and apoptosis may be involved in pain hypersensitivity and other sensory abnormalities after disc herniation. PMID:23711477

Egeland, Nina Gran; Moen, Aurora; Pedersen, Linda Margareth; Brisby, Helena; Gjerstad, Johannes

2013-05-24

119

Gait adaptations in low back pain patients with lumbar disc herniation: trunk coordination and arm swing  

Microsoft Academic Search

Patients with chronic non-specific low back pain (LBP) walk with more synchronous (in-phase) horizontal pelvis and thorax\\u000a rotations than controls. Low thorax–pelvis relative phase in these patients appears to result from in-phase motion of the\\u000a thorax with the legs, which was hypothesized to affect arm swing. In the present study, gait kinematics were compared between\\u000a LBP patients with lumbar disc

Yun Peng Huang; Sjoerd M. Bruijn; Jian Hua Lin; Onno G. Meijer; Wen Hua Wu; Hamid Abbasi-Bafghi; Xiao Cong Lin; Jaap H. van Dieën

2011-01-01

120

ZATRDITEV PO HERNIACIJI LEDVENEGA DISKA L4-L5 S POPREJŠNJO OPERACIJO IN BREZ NJE FUSION IN DISC HERNIATION AT L4-L5 LEVEL WITH OR WITHOUT PREVIOUS SURGERY  

Microsoft Academic Search

Background. The results of treatment in patients with transpedicular instrumented or interbody cage fusion for lumbar disc extrusions at L4-L5 level were retrospectively analyzed. The goal was to determine whether comparable clinical outcome can be achieved in cases with and without previous surgery. Methods. Ten patients who had first symptomatic acute massive disc herniation underwent herniotomy, posterior decompression as necessary,

Samo K. Fokter; Vilibald Vengust

121

Lumbar Periradicular Abscess Mimicking a Fragmented Lumbar Disc Herniation : An Unusual Case  

PubMed Central

We herein describe the case of a focal spontaneous spinal epidural abscess who was initially diagnosed to have a free fragment of a lumbar disc. A 71-year-old woman presented with history of low back and right leg pain. Magnetic resonance imaging suggested a peripherally enhancing free fragment extending down from S1 nerve root axilla. Preoperative laboratory investigation showed elevation of c-reactive protein (CRP), erythrocyte sedimentation rate (ESR) levels. She was taken for surgery and a fluctuating mass at the axilla of S1 nerve was found. When the mass was probed with a dissector, a dark yellow, thick pus drained out. Pus cultures were negative. Patients who present with extreme low back plus leg pain and increased leucocyte count, ESR and CRP levels should raise the suspicion of an infection of a vertebral body or spinal epidural space.

Tekkok, Ismail Hakki

2008-01-01

122

The impact of early recovery on long-term outcomes in a cohort of patients undergoing prolonged nonoperative treatment for lumbar disc herniation.  

PubMed

Object The authors comprehensively studied the recovery of individual patients undergoing treatment for lumbar disc herniation. The primary goal was to gain insight into the variability of individual patient utility scores within a treatment cohort. The secondary goal was to determine how the rates and variability of patient recovery over time, represented by improvement in utility scores, affected long-term patient outcomes. Methods EuroQol Group-5 Dimension (EQ-5D) scores were obtained at baseline and at 2, 4, 8, 12, 26, 38, and 52 weeks for 93 patients treated under a prolonged conservative care protocol for lumbar disc herniation. Gaussian kernel densities were used to estimate the distribution of utility scores at each time point. Logistic regression and multistate Markov models were used to characterize individual patient improvement over time. Fisher exact tests were used to compare the distribution of EQ-5D domain scores. Results The distribution of utility scores was bimodal at 1 year and effectively sorted patients into a "higher" utility group (EQ-5D = 1; 43% of cohort) and a "lower" utility group (EQ-5D ? 0.86; 57% of cohort). Fisher exact tests revealed that pain/discomfort, mobility, and usual activities significantly differed between the 2 utility groups (p ? 0.001). The utility groups emerged at 8 weeks and were stable for the remainder of the treatment period. Using utility scores from 8 weeks, regression models predicted 1-year outcomes with 62% accuracy. Conclusions This study is the first to comprehensively consider the utility recovery of individual patients within a treatment cohort for lumbar disc herniation. The results suggest that most utility is recovered during the early treatment period. Moreover, the findings suggest that initial improvement is critical to a patient's long-term outcome: patients who do not experience significant initial recovery appear unlikely to do so at a later time under the same treatment protocol. PMID:23808581

Cowperthwaite, Matthew C; van den Hout, Wilbert B; Webb, K Michael

2013-06-28

123

Surgical versus Non-Operative Treatment for Lumbar Disc Herniation: Four-Year Results for the Spine Patient Outcomes Research Trial (SPORT)  

PubMed Central

Study Design Concurrent prospective randomized and observational cohort study. Objectives To assess the 4-year outcomes of surgery vs. non-operative care. Background Although randomized trials have demonstrated small short-term differences in favor of surgery, long-term outcomes comparing surgical to non-operative treatment remain controversial. Methods Surgical candidates with imaging-confirmed lumbar intervertebral disc herniation meeting SPORT eligibility criteria enrolled into prospective randomized (501 participants) and observational cohorts (743 participants) at 13 spine clinics in 11 US states. Interventions were standard open discectomy versus usual non-operative care. Main outcome measures were changes from baseline in the SF-36 Bodily Pain (BP) and Physical Function (PF) scales and the modified Oswestry Disability Index (ODI - AAOS/Modems version) assessed at 6 weeks, 3 and 6 months, and annually thereafter. Results Non-adherence to treatment assignment caused the intent-to-treat analyses to underestimate the treatment effects. In the 4-year combined as-treated analysis, those receiving surgery demonstrated significantly greater improvement in all the primary outcome measures (mean change Surgery vs. Non-operative; treatment effect; 95% CI): BP (45.6 vs. 30.7; 15.0; 11.8 to 18.1), PF (44.6 vs. 29.7; 14.9; 12.0 to 17.8) and ODI (?38.1 vs. ?24.9; ?13.2; ?15.6 to ?10.9). The percent working was similar between the surgery and non-operative groups, 84.4% vs. 78.4% respectively. Conclusion In a combined as-treated analysis at 4 years, patients who underwent surgery for a lumbar disc herniation achieved greater improvement than non-operatively treated patients in all primary and secondary outcomes except work status. Trial Registration Spine Patient Outcomes Research Trial (SPORT): Intervertebral Disc Herniation; #NCT00000410; http://www.clinicaltrials.gov/ct/show/NCT00000410?order=2

Weinstein, James N.; Lurie, Jon D.; Tosteson, Tor D.; Tosteson, Anna N. A.; Blood, Emily; Abdu, William A.; Herkowitz, Harry; Hilibrand, Alan; Albert, Todd; Fischgrund, Jeffrey

2009-01-01

124

The NEtherlands Cervical Kinematics (NECK) Trial. Cost-effectiveness of anterior cervical discectomy with or without interbody fusion and arthroplasty in the treatment of cervical disc herniation; a double-blind randomised multicenter study  

PubMed Central

Background Patients with cervical radicular syndrome due to disc herniation refractory to conservative treatment are offered surgical treatment. Anterior cervical discectomy is the standard procedure, often in combination with interbody fusion. Accelerated adjacent disc degeneration is a known entity on the long term. Recently, cervical disc prostheses are developed to maintain motion and possibly reduce the incidence of adjacent disc degeneration. A comparative cost-effectiveness study focused on adjacent segment degeneration and functional outcome has not been performed yet. We present the design of the NECK trial, a randomised study on cost-effectiveness of anterior cervical discectomy with or without interbody fusion and arthroplasty in patients with cervical disc herniation. Methods/Design Patients (age 18-65 years) presenting with radicular signs due to single level cervical disc herniation lasting more than 8 weeks are included. Patients will be randomised into 3 groups: anterior discectomy only, anterior discectomy with interbody fusion, and anterior discectomy with disc prosthesis. The primary outcome measure is symptomatic adjacent disc degeneration at 2 and 5 years after surgery. Other outcome parameters will be the Neck Disability Index, perceived recovery, arm and neck pain, complications, re-operations, quality of life, job satisfaction, anxiety and depression assessment, medical consumption, absenteeism, and costs. The study is a randomised prospective multicenter trial, in which 3 surgical techniques are compared in a parallel group design. Patients and research nurses will be kept blinded of the allocated treatment for 2 years. The follow-up period is 5 years. Discussion Currently, anterior cervical discectomy with fusion is the golden standard in the surgical treatment of cervical disc herniation. Whether additional interbody fusion or disc prothesis is necessary and cost-effective will be determined by this trial. Trial Registration Netherlands Trial Register NTR1289

2010-01-01

125

Influence of cytokine inhibitors on concentration and activity of MMP-1 and MMP-3 in disc herniation  

PubMed Central

Introduction Spontaneous resorption of disc herniation (DH) after sciatica is well documented. The matrix metalloproteinases (MMP)-1 and MMP-3 are enzymes potentially involved in this process. Glucocorticoid injections are commonly used for treatment, and other anti-inflammatory molecules like tumor necrosis factor (TNF) inhibitors are under clinical investigation. However, little is known about the effect of these molecules on DH resorption. Methods DH tissue was harvested from patients undergoing surgery for sciatica. Samples were thoroughly washed. Diced explants were cultured ex-vivo in 1) 0.5 ml Dulbecco's modified Eagle's medium (DMEM) 10% fetal calf serum (FCS), (controls), 2) recombinant interleukin 1 receptor antagonist (IL-1Ra), (100 ng/ml), 3) dexamethasone (10E-5 M), or 4) TNF inhibitor monoclonal antibody (10 ?g/ml). Supernatants were harvested at 48 hours and frozen. Immunocapture activity assays determined total MMP activity, active MMP levels and pro-MMP levels. Results Fourteen DH tissue samples were analysed. Levels of all forms of MMP-3 were higher than the respective levels of MMP-1(P < 0.01). In particular, the median (interquartile range [IQR]) total MMP-3 level was 0.97 (0.47 - 2.19) ng/mg of tissue compared to 0.024 (0.01 - 0.07) ng/mg of total MMP-1 level (P < 0.01). Incubation with IL-1Ra, dexamethasone, or TNF inhibitors significantly decreased levels of all forms of MMP-3 (P < 0.05). Dexamethasone significantly decreased the ratio of active MMP-3 to total MMP-3 activity. A significant inhibitory effect of dexamethasone was observed only on active MMP-1, while IL-1 and TNF inhibitor had no significant effect on any form. Conclusions MMP-3 appears to play a greater role than MMP-1 in DH resorption. Dexamethasone, IL-1-Ra and TNF inhibitor decreased active MMP-3, indicating that the clinical use of these drugs may affect the resorption of DH under certain conditions.

2009-01-01

126

Objective:To evaluate the clinical effect of PCB (a new anterior cervical instrumental system combining an intradiscal cage with an integrated plate) in treating traumatic cervical intervertebral disc herniation  

Microsoft Academic Search

Methods:Anterior decompression and PCB internal fixation were used in 22 patients with traumatic cervical intervertebral disc herniation. They were followed up from 3 to 16 months and analyzed by symptom and image data. Among them, 16 patients underwent fixation at one level and 6 patients at two levels. Results:This technique did not cause intraoperative complications. After surgery no screw backout

MA Yuanzheng; XI Jiancheng; CHEN Xing; GUAN Changyong; QUAN Changbin

127

A case of an 18-year-old male rugby union forward with a C5/C6 central disc herniation.  

PubMed

The patient was an 18-year-old front row forward rugby player who had a history of episodic neck pain for over 2 years following playing games of rugby. The initial event of April 2005 for which the symptoms manifested was a scrum collapse; he continued playing until a front-on tackle occurred when the symptoms dictated that he leave the field and be taken to the local hospital. A diagnosis of a cervical sprain was made and conservative management ensued. During the selections held on January 2008, a medical assessment was made and an MRI found that he had a central disc herniation at C5/C6. He was referred to a spinal orthopaedic surgeon for further treatment. The risks to cervical spinal injuries are illustrated in this case, in a scrum and in the tackle. The prevention of such an injury is discussed. PMID:21686741

Broughton, Henare Renata

2009-04-28

128

Chronic inflammation and compression of the dorsal root contribute to sciatica induced by the intervertebral disc herniation in rats  

Microsoft Academic Search

The pathophysiological mechanisms underlying sciatica and back pain are not well understood. In the present study, a sciatica model was developed to investigate the contributions of inflammation and compression of the dorsal root (DR). The procedure used autologous disc to apply direct pressure to the L5 DR (disc compression, DC group). For control, five additional groups were included: (1) mechanical

Shu-Xun Hou; Jia-Guang Tang; Hui-Sheng Chen; Jun Chen

2003-01-01

129

Conferenza di Consenso. Ossigeno-Ozono Terapia Nel Trattamento Delle Lombosciatalgie da Ernia Discale Con Tecnica Iniettiva Intramuscolare Paravertebrale Istituto Superiore di Sanita Roma 20 Novembre 2006 (Consensus Conference. Lumbar Paravertebral Intramuscular Injection of Oxygen-Ozone in Radicular Pain Caused by Herniated Lumbar Disc. Istituto Superioe di Sanita. Rome, November 20, 2006).  

National Technical Information Service (NTIS)

The present paper is the final document of a Consensus Conference (CC) about Lumbar paravertebral intramuscular injection of oxygen-ozone in radicular pain caused by herniated lumbar disc. In Italy, about 1200 practioners perform this kind of intervention...

A. Napoletano D. Barbina D. Coclite D. Guerrera R. Guerra

2008-01-01

130

Risk factors of recurrent lumbar disk herniation  

PubMed Central

Background: Recurrent lumbar disc herniation (LDH) is a common cause of poor outcomes after lumbar discectomy surgery. Studies focused on risk factors of true recurrent disk herniation at the same level and side, are few. The aim of current study is to evaluate risk factors of recurrent disc herniation in Iranian population. Materials and Methods: We retrospectively reviewed 40 patients with recurrent disc herniation and 120 patients without recurrence to evaluate possible risk factors for herniation recurrence. A clinically significant recurrent herniation was defined as a disc herniation causing leg pain with radiographic (MRI) evidence of disc material at the same side and level of the index surgery causing impingement, compression, or deviation of nerve tissue. A series of patients without recurrence was used for comparison to identify possible risk factors for recurrent LDH. Results: There was significant difference between groups with and without LDH in sex (P = 0.003), smoking habit (P = 0.004), height (P = 0.04), weight (P = 0.006) and occupational characteristic (P < 0.001). By putting these differences in logistic regression analysis, it showed that gender (male), taller height, heavy works and being smoker could predict lumbar disc herniation recurrence. Conclusion: Considering sex, smoking and heavy works as predictors of recurrent LDH, surgeons should advice their patients to limit hard work and put away smoking especially in tall and male ones to prevent LDH recurrence.

Shimia, Mohammad; Babaei-Ghazani, Arash; Sadat, Bina Eftekhar; Habibi, Behnaz; Habibzadeh, Afshin

2013-01-01

131

Percutaneous Endoscopic Lumbar Discectomy and Annuloplasty for Lumbar Disc Herniation at the Low Two Contiguous Levels: Single-Portal, Double Surgeries.  

PubMed

Study Design Technical case report.Objective The authors report surgical experience of treating contained or noncontained lumbar disc herniation (LDH) at the L3-L4 and L4-L5 or L4-L5 and L5-S1 levels by transforaminal percutaneous endoscopic lumbar discectomy and annuloplasty (PELDA) through the single entry point.Summary of Background Data When there are concurrent LDHs involving lower two levels simultaneously, PELDA has not been performed.Methods Between March 2008 and May 2011, eight patients presented with back pain or radicular lower limb pain. Upon radiologic examination using magnetic resonance imaging, the patients were diagnosed with central or paramedian LDH at low spine levels (L3-L4 and L4-L5 or L4-L5 and L5-S1) consistent with their clinical presentations. We performed double PELDA at the affected two levels simultaneously through a single skin portal.Results The symptoms were relieved dramatically, and all patients were discharged the next day. There was no radiologic instability during the follow-up period.Conclusions Transforaminal PELDA to treat two levels of LDH through a single portal could be considered as one of the minimally invasive treatment modalities that avoids conventional open surgery. PMID:23765920

Hur, Jung-Woo; Kim, Jin-Sung; Shin, Myung-Hoon; Ryu, Kyeong-Sik; Park, Chun-Kun; Lee, Sang-Ho

2013-06-13

132

A controlled case study of the relationship between environmental risk factors and apoptotic gene polymorphism and lumbar disc herniation.  

PubMed

To explore the etiologic role of apoptosis-related genes, environmental risk factors, and their interaction in the occurrence of lumbar disk herniation (LDH), a controlled case study was performed with 128 LDH patients and 132 age- and sex-matched controls. Matrix-assisted laser desorption/ionization, time-of-flight mass spectrometry assay was used to analyze the genotype of nine polymorphism sites in three genes, including Fas -1377G/A rs2234767, Fas -670G/A rs1800682, Fas rs2147420, Fas rs2296603, Fas rs7901656, Fas rs1571019, Fas ligand (FasL) -844C/T rs763110, caspase 9 (CASP9) -1263A>G rs4645978, and CASP9 -712C>T rs4645981. The patients and controls showed similar age and sex, but had significant differences in lumbar load, bed type, amateur sports, and leisure activities (P < 0.05). The correlation analysis revealed that polymorphism of FasL -844C/T (rs763110) and CASP9 -1263A>G (rs4645978) had a significant correlation with LDH, indicating that the genotypes of FasL -844C/T TT and CASP9 -1263A>G GG are probably high-risk genotypes for LDH. The results of environment-gene interaction analysis revealed that, in LDH, the interaction of the FasL -844TT genotype and level III to IV lumbar load was consistent with the ultramultiplying model, and the interaction of the CASP9 rs4645978 GG genotype and level III to IV lumbar load was consistent with the submultiplicative model. Therefore, the risk of LDH was determined by both environmental and genetic risk factors, and the mechanisms of interactions between different genotypes and environmental factors also differed. PMID:23141929

Zhang, Yin-Gang; Zhang, Feng; Sun, Zhengmin; Guo, Wentao; Liu, Jian; Liu, Miao; Guo, Xiong

2012-11-07

133

The effect of low back pain on the daily activities of patients with lumbar disc herniation: a Turkish military hospital experience.  

PubMed

This study was performed to assess disability on daily living activities, which developed secondary to low back pain, in patients with lumbar disc herniation and treated either conservatively or surgically. The study was performed between November 2008 and June 2009. Visual analogue scale (VAS) was used to measure the intensity of pain, and the Oswestry Disability Index (ODI) was used to assess the disability of the patients on daily living activities. Of the 112 patients, 55 were women and 57 were men. The mean age was 39.68 years for the conservative treatment group and 46.46 years the for surgical treatment group. In the pretreatment period, the patients who were selected for surgical treatment had higher VAS score and ODI than did the patients who were selected for conservative treatment. The disability areas that were reported in the pretreatment period were walking, sleeping, standing, and traveling for the surgical treatment group and self-care, sitting, and social life areas for the conservative treatment group. When the ODI and VAS score of the patients were statistically compared at the third month of posttreatment period, the scores were significantly low in the surgical treatment group. The disability areas that were reported at the third month of posttreatment period were weight lifting, self-care, and walking for the surgical treatment group and social life, sleeping, sitting, and standing for the conservative treatment group. This study found that patients with low back pain experience physical disabilities due to pain. Their daily living activities are affected by these disabilities and the intensity of pain affects the level of disability. Knowledge of the disability areas caused by low back pain plays an important role in the determination of nursing care and content of the education which will be offered to the patients. The use of scale on the patient's care is important to form a common language in nursing and to obtain evidence-based data related to the patients. PMID:22367273

Kose, Gulsah; Hatipoglu, Sevgi

2012-04-01

134

Childhood intervertebral disc calcification  

Microsoft Academic Search

Two cases of intervertebral disc calcification in children are reported. A 13-year-old boy presented with right subscapular pain radiating into the axilla with radiographic demonstration of multiple calcified intervertebral discs and a herniated fragment of calcified nucleus pulposus at T2–3. His condition improved with conservative therapy, and follow-up radiographic evaluation revealed resolution of the herniated calcified disc material. A second

B. Theo Mellion; John P. Laurent; William C. Watters

1993-01-01

135

Brain herniation  

MedlinePLUS

... blinking, gagging, pupils reacting to light) Loss of consciousness Respiratory arrest (no breathing) Wide (dilated) pupils and ... nervous system (neurological) exam shows changes in alertness (consciousness). Depending on the severity of the herniation and ...

136

Comparative Effectiveness Evidence from the Spine Patient Outcomes Research Trial: Surgical vs. Non-Operative Care for Spinal Stenosis, Degenerative Spondylolisthesis and Intervertebral Disc Herniation  

PubMed Central

Study Design Cost-effectiveness analysis of a randomized plus observational cohort trial Objective Analyze cost-effectiveness of Spine Patient Outcomes Research Trial (SPORT) data over 4 years comparing surgery with non-operative care for three common diagnoses: spinal stenosis (SpS), degenerative spondylolisthesis (DS) and intervertebral disc herniation (IDH). Summary of Background Data Spine surgery rates continue to rise in the US, but the safety and economic value of these procedures remains uncertain. Methods Patients with image-confirmed diagnoses were followed in randomized or observational cohorts with data on resource use, productivity and EQ-5D health state values measured at 6 weeks, 3, 6, 12, 24, 36, and 48 months. For each diagnosis, cost per quality-adjusted life year (QALY) gained in 2004 US Dollars was estimated for surgery relative to non-operative care using a societal perspective, with costs and QALYs discounted at 3% per year. Results Surgery was performed initially or during the 4-year follow-up among 414/634 (65.3%) SPS, 391/601 (65.1%) DS and 789/1192 (66.2%) IDH patients. Surgery improved health, with persistent QALY differences observed through 4 years (SpS QALY gain 0.22; 95%CI: 0.15, 0.34; DS QALY gain 0.34, 95%CI: 0.30, 0.47; IDH QALY gain 0.34, 95%CI: 0.31, 0.38). Costs per QALY gained decreased for SPS from $77,600 at 2 years to $59,400 (95%CI: $37,059, $125,162) at 4 years; for DS from $115,600 to $64,300/QALY (95%CI: $32,864, $83,117); and for IDH from $34,355 to $20,600/QALY (95%CI: $4,539, $33,088). Conclusions Comparative effectiveness evidence for clearly defined diagnostic groups from SPORT shows good value for surgery compared with non-operative care over 4-years.

Tosteson, Anna N. A.; Tosteson, Tor D.; Lurie, Jon D.; Abdu, William; Herkowitz, Harry; Andersson, Gunnar; Albert, Todd; Bridwell, Keith; Zhao, Wenyan; Grove, Margaret R.; Weinstein, Milton C.; Weinstein, James N.

2012-01-01

137

A very rare cause of low-back pain and sciatica: deep vein thrombosis due to absence of the inferior vena cava mimicking the clinical and radiological signs of lumbar disc herniation.  

PubMed

The authors report a very rare cause of low-back pain and sciatica in a patient with iliac vein thrombosis attributed to absence of the infrarenal segment of the inferior vena cava (IVC) with massively dilated venous collaterals draining via a paraspinal plexus into the azygous system. This 21-year-old man presented with acute low-back pain radiating to the left ventral thigh. The initial CT scan revealed an intraspinal lesion that mimicked lumbar disc herniation. Further clarification revealed an iliac vein thrombosis, which was triggered by the absence of the infrarenal segment of the IVC, a very rare vascular anomaly. Collateral venous return was developed and led to lumbar varicosities and epidural vein engorgements. Laboratory examinations revealed factor V mutation as a predisposing factor for thrombosis. The patient's symptoms were relieved with anticoagulation and antiinflammatory therapy. Absence of the infrarenal IVC associated with iliac vein thrombosis should be regarded as a very rare cause of radicular and low-back pain, and this condition can mimic the clinical and radiological signs of lumbar disc herniation. Sciatica might be the first clinical manifestation of this rare venous anomaly. PMID:21529127

Kogias, Evangelos; Kircher, Achim; Deininger, Martin Hermann; Psarras, Nikolaos; Keck, Tobias; Schäfer, Arnd-Oliver; Hubbe, Ulrich

2011-08-01

138

Thoracic extruded disc mimicking spinal cord tumor  

Microsoft Academic Search

Background context: Thoracic disc herniation is a rare condition. Distinguishing between a herniated disc and tumor for a lesion found at the thoracic level can be a diagnostic challenge.Purpose: To describe a case of thoracic disc herniation that mimicked a spinal cord tumor.Study design\\/setting: Case report and review of the literature.Patient sample: Case report.Outcome measures: Report of postoperative symptoms.Methods\\/description: A

Bikash Bose

2003-01-01

139

Pathogenesis of sciatic pain: role of herniated nucleus pulposus and deformation of spinal nerve root and dorsal root ganglion  

Microsoft Academic Search

The basic pathophysiologic mechanisms related to disc herniation and sciatica are poorly understood. Recently it was demonstrated that nucleus pulposus from an intervertebral disc could induce structural and functional changes in adjacent nerve roots when applied epidurally, however, it is not known if such changes are painful. In a model for inducing disc herniation in the rat, we found that

Kjell Omarker; Robert R. Myers

1998-01-01

140

Clinical Results of a Single Central Interbody Fusion Cage and Transpedicle Screws Fixation for Recurrent Herniated Lumbar Disc and Low-Grade Spondylolisthesis  

Microsoft Academic Search

Background: The posterior lumbar interbody fusion (PLIF) procedure allows restoration of the weight-bearing capacity to a more physiological ventral position and maintenance of disc space height. However, the procedure can be technically difficult and may cause complications. It has always been performed bilater- ally with paired cages; a single central cage has not been commonly used. Methods: Twenty-eight patients who

Kuo-Feng Huang; Tzu-Yung Chen

141

Cervical arthroplasty using ProDisc-C Case Report  

PubMed Central

Cervical disc replacement is an emerging motion-preserving technology in the surgical treatment of the cervical degenerative disc disorders used as an alternative to the classic interbody fusion. We present a case report of a patient diagnosed with C6-7 right disc herniation who underwent anterior discectomy and received a total disc replacement using ProDisc C artificial disc prosthesis.

Nica, DA; Copaciu, R

2013-01-01

142

Prolonged conservative care versus early surgery in patients with sciatica caused by lumbar disc herniation: two year results of a randomised controlled trial  

Microsoft Academic Search

Objectives To evaluate the effects of early lumbar disc surgery compared with prolonged conservative care for patients with sciatica over two years of follow-up.Design Randomised controlled trial.Setting Nine Dutch hospitals.Participants 283 patients with 6-12 weeks of sciatica.Interventions Early surgery or an intended six months of continued conservative treatment, with delayed surgery if needed.Main outcome measures Scores from Roland disability questionnaire

Wilco C Peul; Wilbert B van den Hout; Ronald Brand; Ralph T W M Thomeer; Bart W Koes

2008-01-01

143

Quantitative Discomanometry: Correlation of Intradiscal Pressure Values to Pain Reduction in Patients With Intervertebral Disc Herniation Treated With Percutaneous, Minimally Invasive, Image-Guided Techniques  

SciTech Connect

Purpose: To illustrate quantitative discomanometry's (QD) diagnostic efficacy and predictive value in discogenic-pain evaluation in a prospective study correlating intradiscal pressure values with pain reduction after percutaneous image-guided technique (i.e., percutaneous decompression, PD). Materials and Methods: During the last 3 years, 36 patients [21 male and 15 female (mean age 36 {+-} 5.8 years)] with intervertebral disc hernia underwent QD before PD. Under absolute sterilization and fluoroscopy, a mixture of contrast medium and normal saline (3:1 ratio) was injected. A discmonitor performed a constant rate injection and recorded pressure and volume values, thus producing the relative pressure-volume curve. PD was then performed. Pain reduction and improved mobility were recorded at 3, 12, and 24 months after PD using clinical evaluation and a numeric visual scale (NVS; 0 to 10 units). Results: Mean pain values of 7.5 {+-} 1.9 (range 4 to 8) NVS units were recorded before PD; these decreased to 2.9 {+-} 2.44 at 3 months, 1.0 {+-} 1.9 at 12 months, and 1.0 {+-} 1.9 NVS units at 24 months after PD. Recorded correlations (pressure, volume, significant pain-reduction values) with bilateral statistical significance included a maximum injected volume of 2.4 ml (p = 0.045), P{sub o} < 14 psi [initial pressure required to inject 0.1 ml of the mixture inside the disc (p = 0.05)], P{sub max} {<=} 65 psi [greatest pressure value on the curve (p = 0.018)], and P{sub max} - P{sub o} {<=} 47 psi (p = 0.038). Patients meeting these pressure or volume cut-off points, either independently or as a total, had significant pain reduction (>4 NVS units) after PD. No complications were noted. Conclusions: QD is an efficient technique that may have predictive value for discogenic pain evaluation. It might serve as a useful tool for patient selection for intervertebral disc therapies.

Filippiadis, Dimitrios K., E-mail: dfilippiadis@yahoo.gr; Mazioti, A., E-mail: argyromazioti@yahoo.gr; Papakonstantinou, O., E-mail: sogofianol@gmail.com; Brountzos, E., E-mail: ebrountz@med.uoa.gr [University General Hospital 'Attikon', Second Radiology Department (Greece); Gouliamos, A., E-mail: agouliam@med.uoa.gr [University General Hospital 'Areteion', First Radiology Department (Greece); Kelekis, N., E-mail: kelnik@med.uoa.gr; Kelekis, A., E-mail: akelekis@med.uoa.gr [University General Hospital 'Attikon', Second Radiology Department (Greece)

2012-10-15

144

Percutaneous lumbar disc decompression.  

PubMed

Chronic low back pain is a major social, economic, and healthcare issue in the United States. Various techniques are utilized in managing discogenic pain, with or without disc herniation. Percutaneous techniques are rapidly replacing traditional open surgery in operations requiring discectomy, decompression, and fusion. The percutaneous access to the disc was first used in the 1950s to biopsy the disc with needles. Percutaneous access to the disc using endoscopic techniques was developed in the 1970s. Technical advances in the use of intradiscal therapies led to the development of intradiscal electrothermal annuloplasty (IDET), DISC Nucleoplasty, and DeKompressor, along with laser-assisted, endoscopic, and Nucleotome disc decompressions. The indications for percutaneous lumbar disc decompression include low back and lower extremity pain caused by a symptomatic disc. Internal disc disruptions and disc herniations are common causes of low back and/or lower extremity pain which may become chronic, if not diagnosed and treated. Annular tears lead to migration of the nuclear material and deranged internal architecture. In the chronically damaged intervertebral disc, leakage of nuclear material from annular tears can initiate, promote, and continue the inflammatory process and delay or stop recovery of vital remaining intradiscal tissue. The most often stated goal of central nuclear decompression is to lower the pressure in the nucleus and to allow room for the herniated fragment to implode inward. Provocative discography prior to percutaneous lumbar disc decompression is recommended. Percutaneous disc decompression may result in a small number of complications but occasionally, these could be serious. PMID:16703975

Singh, Vijay; Derby, Richard

2006-04-01

145

Can Prevention of a Reherniation Be Investigated? Establishment of a Herniation Model and Experiments With an Anular Closure Device  

PubMed Central

Study Design. Biomechanical in vitro study. Objective. To establish a reliable in vitro herniation model with human cadaver spines that enables evaluation of anular closure devices. Summary of Background Data. Biomechanically, it is desirable to close anulus defects after disc herniation to preserve as much nucleus as possible. Multiple anular closure options exist to prevent reherniation. A reliable test procedure is needed to evaluate the efficacy and reliability of these implants. Methods. Two groups of human lumbar segments (n = 6 per group) were tested under cyclic loading until herniation occurred or 100,000 load cycles were applied. One group contained moderate/severe degenerated discs. A second group had mild degenerated discs. Intradiscal pressure was measured in the intact state to confirm disc quality. If herniation occurred, the extruded material was reinserted into the disc and the anulus defect was treated with the Barricaid anular closure device (Intrinsic Therapeutics, Inc., Woburn, MA). Disc height and 3-dimensional flexibility of the specimens in the intact, defect, and implanted states were measured under pure moments in each principal motion plane. Afterwards, provocation of reherniation was attempted with additional 100,000 load cycles. Results. Likelihood of herniation was strongly linked to disc degeneration and supported by the magnitude of intradiscal pressure. In moderate/severe degenerated discs, only 1 herniation was created. In mild degenerated discs, herniations were reliably created in all specimens. Using this worst-case model, herniation caused a significant reduction of disc height, which was nearly restored with the implant. In no case was reherniation or implant migration visible after 100,000 load cycles after Barricaid implantation. Conclusion. We established a human herniation model that reliably produced nucleus extrusion during cyclic loading by selecting specimens with low disc degeneration. The Barricaid seems to prevent nucleus from reherniating. The reliability of this method suggests the opportunity to investigate other anulus closure devices and nucleus replacement techniques critically.

Wilke, Hans-Joachim; Ressel, Lena; Heuer, Frank; Graf, Nicolas; Rath, Stefan

2013-01-01

146

Computed tomographic characteristics of acute thoracolumbar intervertebral disc disease in dogs  

PubMed Central

Forty canine patients with a presumptive diagnosis of the intervertebral disc herniation at the thoracolumbar region were imaged. A neurological examination was performed and all patients were classified under four grades by the examination. The degrees of attenuation of the herniated disc material were measured in Housefield units (HU) in each image. The ratio of the area to herniated disc material and the height to disc material were measured. The clinical grade was correlated with the area ratio of the herniated disc material to the spinal cord, but not correlated with the height ratio of that. In the patients with epidural hemorrhage at surgery, HUs of the herniated disc material was lower than those with no epidural hemorrhage at surgery. Non-contrast computed tomography scans of the spine can be useful in diagnosing acute intervertebral disc disease in chondrodystrophoid breeds, evaluating patient status and identifying concurrent epidural hemorrhage.

Lim, Changyun; Kweon, Oh-Kyeong; Choi, Min-Cheol; Choi, Jihye

2010-01-01

147

Gene therapy for degenerative disc disease  

Microsoft Academic Search

Degenerative disc disease (DDD) is a chronic process that can become clinically manifest in multiple disorders such as idiopathic low back pain, disc herniation, radiculopathy, myelopathy, and spinal stenosis. The limited available technology for the treatment of these and other pathologic and disabling conditions arising from DDD is highly invasive (eg, surgical discectomy and fusion), manifesting a certain degree of

S Sobajima; JS Kim; LG Gilbertson; JD Kang

2004-01-01

148

PAIN, TRUNK MUSCLE STRENGTH, SPINE MOBILITY AND DISABILITY FOLLOWING LUMBAR DISC SURGERY  

Microsoft Academic Search

Objective: To study associations between pain, trunk muscle strength, flexibility and disability in patients with lumbar disc herniation 2 months after surgery. Design: Clinical cross-sectional survey. Participants: 172 operated lumbar disc herniation patients. Methods: Back and leg pain on Visual Analogue Scale, Oswestry Disability Index and Brief Depression Scale were applied to assess the subjectively perceived outcome. Isometric and dynamic

Arja Häkkinen; Jari Ylinen; Hannu Kautiainen; Olavi Airaksinen; Arto Herno; Ulla Tarvainen; Ilkka Kiviranta

2003-01-01

149

Lumbar disc nucleoplasty using coblation technology: clinical outcome  

Microsoft Academic Search

Background and purposeAlthough the standard treatment for lumbar disc herniation is lumbar microdiscectomy, nucleoplasty offers a new technique with encouraging results in well selected cases. Nucleoplasty is a minimally invasive technique that manages intradiscal herniation through energy based removal of part of the nucleus pulposus. The purpose of this study was to assess the safety and clinical outcome of the

Alaa Azzazi; Sherif AlMekawi; Mostafa Zein

2010-01-01

150

Percutaneous treatment of lumbar intervertebral disc hernias with discogel.  

PubMed

A new percutaneous technique for the treatment of the backache and sciatica related to the lumbar disc herniation was applied in 34 patients at 40 levels. The technique is easy, safe, efficacious and without complications. In particular it is useful for the diagnosis and treatment of the underestimated "internal disc disruption" syndrome. PMID:24059722

Pardatscher, K; Volpentesta, G; Bombardieri, C; Giaquinta, A

2011-09-02

151

Lumbar intervertebral disc cyst as a cause of radiculopathy  

Microsoft Academic Search

Background context: Lumbar radiculopathy is commonly caused by degenerative conditions such as a herniated disc or lumbar spinal stenosis. Less common etiologies include intraspinal extradural masses such as synovial cysts and gas-containing ganglion cysts. Intraspinal extradural cysts that communicate with the intervertebral disc are a rare entity and thus, an uncommon cause of lumbar radiculopathy. There are only ten cases

Gerard K Jeong; John A Bendo

2003-01-01

152

46 CFR 64.61 - Rupture disc.  

Code of Federal Regulations, 2011 CFR

...SECURITY (CONTINUED) MARINE ENGINEERING MARINE PORTABLE TANKS AND CARGO HANDLING SYSTEMS Pressure Relief Devices and Vacuum Relief Devices for MPTs § 64.61 Rupture disc. If a rupture disc is the only pressure relief device on the tank,...

2011-10-01

153

Microendoscopic discectomy (MED) for lumbar disc prolapse  

Microsoft Academic Search

Microendoscopic discectomy (MED), which combines traditional lumbar microsurgical techniques with endoscopy, is being used as a minimally invasive procedure for lumbar disc herniation. We reviewed 30 patients who underwent MED at our institution and compared their outcome with that of patients subjected to the conventional method. Laboratory data suggested that MED was less invasive surgery. Moreover, MED allowed an early

Hiroyuki Nakagawa; Mikio Kamimura; Shigeharu Uchiyama; Kenji Takahara; Toshiro Itsubo; Tadaatsu Miyasaka

2003-01-01

154

Prevalence of spinal disc disease among interventional cardiologists.  

PubMed

A suspected, but undocumented, excess of axial skeletal disease among interventional cardiologists (possibly a consequence of lead apron use) was investigated by comparing questionnaire responses from cardiologists, orthopedic surgeons, and rheumatologists (n = 714). Cardiologists reported more neck and back pain, more subsequent time lost from work, and a higher incidence of cervical disc herniations, as well as multiple level disc disease (all p <0.01): "interventionalist's disc disease" is a confirmed entity. PMID:9024739

Ross, A M; Segal, J; Borenstein, D; Jenkins, E; Cho, S

1997-01-01

155

Intervertebral disc replacement for cervical degenerative disease – clinical results and functional outcome at two years in patients implanted with the Bryan ® cervical disc prosthesis  

Microsoft Academic Search

Summary  \\u000a Background. This is a prospective study of patients with degenerative cervical disease who underwent ventral discectomy and disc replacement\\u000a with the Bryan® cervical disc prosthesis. The objective was to investigate clinical outcome at 2 years of patients implanted with the Bryan® disc and to evaluate function of the implant itself.\\u000a \\u000a \\u000a Methods. Fifty-four consecutive patients with cervical disc herniation and\\/or

V. Heidecke; W. Burkert; M. Brucke; N. G. Rainov

2008-01-01

156

Intra- and inter-observer reliability of MRI examination of intervertebral disc abnormalities in patients with cervical myelopathy  

Microsoft Academic Search

PurposeIntervertebral cervical disc herniation (CDH) is a relatively common disorder that can coexist with degenerative changes to worsen cervicogenic myelopathy. Despite the frequent disc abnormalities found in asymptomatic populations, magnetic resonance imaging (MRI) is considered excellent at detecting cervical spine myelopathy (CSM) associated with disc abnormality. The objective of this study was to investigate the intra- and inter-observer reliability of

Andresa Braga-Baiak; Anand Shah; Ricardo Pietrobon; Larissa Braga; Arnolfo Carvalho Neto; Chad Cook

2008-01-01

157

[Compression syndromes in the disc-radicular conflict in patients with intervertebral disc lesion].  

PubMed

One thousand and thirty patients with proved L(5)/S(1)disc herniations were examined. The dynamics of disease in acute stage was studied using ultrasonography and electromyography in 3 groups of patients: 280 with lumboischialgia, 520 with the root syndrome and 230 controls without back pain. It has been shown that edematous epiduritis and venous stas in the superincumbent spinal movement segment is a main pathogenetic mechanism of acute phase of the disc-radicular conflict. Focal myelopathy is a pathogenetic mechanism of radiculopathy in the disc-recticular conflict. Compression and reflex syndromes are caused by the common mechanisms and their differentiation by clinical presentations has a conditional character. PMID:19672222

Sitel', A B; Kuz'minov, K O; Kanaev, S P; Nikonov, S V; Beliakov, V V

2009-01-01

158

Genome-wide association study in Dachshund: identification of a major locus affecting intervertebral disc calcification.  

PubMed

Intervertebral disc calcification and herniation commonly affects Dachshund where the predisposition is caused by an early onset degenerative process resulting in disc calcification. A continuous spectrum of disc degeneration is seen within and among dog breeds, suggesting a multifactorial etiology. The number of calcified discs at 2 years of age determined by a radiographic evaluation is a good indicator of the severity of disc degeneration and thus serves as a measure for the risk of developing intervertebral disc herniation. The aim of the study was to identify genetic variants associated with intervertebral disc calcification in Dachshund through a genome-wide association (GWA) study. Based on thorough radiographic examinations, 48 cases with ? 6 disc calcifications or surgically treated for disc herniation and 46 controls with 0-1 disc calcifications were identified. GWA using the Illumina CanineHD BeadChip identified a locus on chromosome 12 from 36.8 to 38.6 Mb with 36 markers reaching genome-wide significance (P(genome) = 0.00001-0.026). This study suggests that a major locus on chromosome 12 harbors genetic variations affecting the development of intervertebral disc calcification in Dachshund. PMID:21846751

Mogensen, Mette Sloth; Karlskov-Mortensen, Peter; Proschowsky, Helle Friis; Lingaas, Frode; Lappalainen, Anu; Lohi, Hannes; Jensen, Vibeke Frøkjær; Fredholm, Merete

159

Unusual case of camptocormia triggered by lumbar-disc herniation  

Microsoft Academic Search

A 21-year-old male patient with low back pain and marked forward bending was presented. The exaggerated lumbar flexion was\\u000a preventing him to stand in erect posture but disappeared while lying. The symptoms had begun after he had lifted a heavy object.\\u000a Straight-leg-raising test could not be performed properly because of the exaggerated pain. The light-touch sense was decreased\\u000a on L5

Iltekin Duman; Korhan Baklac?; Arif Kenan Tan; Tunc Alp Kalyon

2008-01-01

160

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

PubMed

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. PMID:6217517

Richard, J C; Mazas, F

1982-01-01

161

Lumbar micro disc surgery with and without autologous fat graft  

Microsoft Academic Search

Epidural scarring is one of the possible complications after lumbar disc surgery. Perineural scar tissue has been considered\\u000a responsible for recurrent neurological symptoms in patients operated on for disc herniation and leads to a high rate of unsatisfactory\\u000a results. In addition, postoperative scars may increase the technical difficulty and risk of subsequent procedures. Various\\u000a materials have been used in animal

Kai Bernsmann; Jürgen Krämer; Ilias Ziozios; Jörg Wehmeier; M. Wiese

2001-01-01

162

Reoperation after lumbar disc surgery: Results in 130 cases  

Microsoft Academic Search

Summary Out of a series of 1850 cases operated upon for lumbar disc herniation 130 underwent re-operation because of persistent or recurrent symptoms. Re-operation was successful in 62%. The prognosis of re-operation was not related to special clinical symptoms and signs but only to the operative findings.

J. Fandifio; C. Botana; A. Viladrich; J. Gomez-Bueno

1993-01-01

163

Traumatic herniation of the buccal fat pad  

Microsoft Academic Search

Two new cases of traumatic herniation of the buccal fat pad are presented. The herniated fat pad was repositioned in case 1 and was excised in case 2. There was no recurrence after surgery in each case. Reviewing the literature, the lesion usually occurred in infants or young children under the age of 4 years as a result of traumatic

Norio Horie

2001-01-01

164

46 CFR 64.61 - Rupture disc.  

Code of Federal Regulations, 2012 CFR

...disc. 64.61 Section 64.61 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE ENGINEERING MARINE PORTABLE TANKS AND CARGO HANDLING SYSTEMS Pressure Relief Devices and Vacuum Relief Devices for MPTs...

2012-10-01

165

Percutaneous disc decompression using nucleoplasty.  

PubMed

The objective of this study was to evaluate the effectiveness of Nucleoplasty for decompression of contained herniated discs, in a prospective, single site study that evaluated 49 consecutive patients with complaints of back with or without leg pain secondary to a contained focal protrusion. Access to the disc was obtained via the posterolateral discography approach, with a 17-gauge introducer needle inserted through the annulus and into the nucleus. The introducer remained in place within the outer annulus during the entire procedure, providing access for the SpineWand into the nucleus. The procedure was performed on an outpatient basis. One month, three month, six-month and twelve month outcomes were assessed by the treating physician and support staff. Success was defined as a minimum 2-point reduction on a Visual Analog Scale (VAS), patient satisfaction, absence of narcotic use, and return to work if not working secondary to back pain. The pre-procedure and post-procedure VAS differences were 4.28 (p<0.001), 4.66 (p<0.001), 4.75 (p<0.001), and 3.3 (p=0.002) at the one month, 3 month, 6 month, and 12 month intervals respectively. Overall, there was a 79% success rate, with 67% success in the group of patients that had previous surgery and 82% success in the group that had no prior surgical intervention. Results indicate that Nucleoplasty may be a promising and efficacious minimally invasive procedure for the treatment of symptoms associated with contained herniated discs. Randomized, controlled studies with subgroup analysis are required to further delineate the role for this procedure. PMID:16902662

Sharps, Lewis S; Isaac, Zacharia

2002-04-01

166

Deuk Laser Disc Repair® is a safe and effective treatment for symptomatic cervical disc disease  

PubMed Central

Background: Deuk Laser Disc Repair® is a new full-endoscopic surgical procedure to repair symptomatic cervical disc disease. Methods: A prospective cohort of 66 consecutive patients underwent cervical Deuk Laser Disc Repair® for one (n = 21) or two adjacent (n = 45) symptomatic levels of cervical disc disease and were evaluated postoperatively for resolution of headache, neck pain, arm pain, and radicular symptoms. All patients were candidates for anterior cervical discectomy and fusion (ACDF) or arthroplasty. The Mann–Whitney Wilcoxon test was used to calculate P values. Results: All patients (n = 66) had significant improvement in preoperative symptoms with an average symptom resolution of 94.6%. Fifty percent (n = 33) had 100% resolution of all preoperative cervicogenic symptoms. Only 4.5% (n = 3) had less than 80% resolution of preoperative symptoms. Visual analog scale (VAS) significantly improved from 8.7 preoperatively to 0.5 postoperatively (P < 0.001) for the cohort. Average operative and recovery times were 57 and 52 minutes, respectively. There were no perioperative complications. Recurrent disc herniation occurred in one patient (1.5%). Average postoperative follow-up was 94 days and no significant intergroup difference in outcomes was observed (P = 0.111) in patients with <90 days (n = 52) or >90 days (n = 14, mean 319 days) follow-up. No significant difference in outcomes was observed (P = 0.774) for patients undergoing one or two level Deuk Laser Disc Repair®. Patients diagnosed with postoperative cervical facet syndrome did significantly worse (P < 0.001). Conclusion: Deuk Laser Disc Repair® is a safe and effective alternative to ACDF or arthroplasty for the treatment of one or two adjacent symptomatic cervical disc herniations with an overall success rate of 94.6%.

Deukmedjian, Ara J.; Jason Cutright, S. T.; Augusto Cianciabella, PA-C; Deukmedjian, Arias

2013-01-01

167

Evaluation of percutaneous disc decompression using coblation in chronic back pain with or without leg pain.  

PubMed

The intervertebral disc is the focal point of pathology for most low back pain. Contained disc herniation is a common cause of low back pain and, when unresponsive to conservative measures, is often treatable by disc decompression. To evaluate the safety and efficacy of percutaneous disc decompression using Coblation (Nucleoplasty) in the treatment of back and/or leg pain associated with contained disc herniation, a prospective, nonrandomized cohort analysis was conducted in an interventional pain management practice. Patients were followed for twelve months post procedure. Eighty patients who presented with discogenic low back pain with or without radicular pain associated with contained disc herniation underwent percutaneous disc decompression using Coblation technology (Nucleoplasty) after failing at least 3 months of conservative and injection therapies. Overall, 75% of patients indicated a decrease in their numeric pain scores at 12 months with a statistically significant reduction in numeric pain scores of 2.43 +/- 2.47 (p<0.0001) compared to baseline. A total of 54% of patients indicated pain relief of 50% or more at twelve months. Additionally, significant improvement was reported by 54%, 44%, and 49% of patients in sitting, standing and walking abilities, respectively, at 12 months. There were no instances of complications. These results indicate that disc decompression using Coblation (Nucleoplasty) is a safe and efficacious procedure for reducing discogenic low back pain with or without leg pain. PMID:16880871

Singh, Vijay; Piryani, Chandur; Liao, Katherine

2003-07-01

168

TNFa-stimulated gene product (TSG-6) and its binding protein, IaI, in the human intervertebral disc: new molecules for the disc  

Microsoft Academic Search

Inflammation and irritation of the nerve roots has been indicated as an important factor in the pain associated with symptomatic disc herniations. Tumour necrosis factor ? (TNF?) is now believed to be involved in this pathway. TNF? causes connective tissue cells in culture to synthesise a glycoprotein, TNF?-stimulated gene-6 (TSG-6). TSG-6 is found in inflammatory diseases of related connective tissues,

Sally Roberts; H. Evans; J. Menage; J. P. G. Urban; M. T. Bayliss; S. M. Eisenstein; M. S. Rugg; C. M. Milner; S. Griffin; A. J. Day

2005-01-01

169

Chronic lumbar extradural haematoma simulating disc syndrome  

PubMed Central

Two patients presenting with a clinical picture of nerve root compression suggestive of the herniated disc syndrome are reported. In both the diagnosis proved to be chronic encapsulated extradural haematoma. Recognition of this entity at the time of surgical exposure should render the surgical dissection easier. The postoperative results in both were excellent. One of these patients was on chronic anticoagulant therapy and the unusual location and good prognosis of extradural haematoma in the lumbar spinal canal in such patients is emphasized. In the other, the haematoma developed after a minor back injury, which introduces medico-legal implications. Images

Devadiga, K. V.; Gass, H. H.

1973-01-01

170

Gene expression profile analysis of human intervertebral disc degeneration  

PubMed Central

In this study, we used microarray analysis to investigate the biogenesis and progression of intervertebral disc degeneration. The gene expression profiles of 37 disc tissue samples obtained from patients with herniated discs and degenerative disc disease collected by the National Cancer Institute Cooperative Tissue Network were analyzed. Differentially expressed genes between more and less degenerated discs were identified by significant analysis of microarray. A total of 555 genes were significantly overexpressed in more degenerated discs with a false discovery rate of < 3%. Functional annotation showed that these genes were significantly associated with membrane-bound vesicles, calcium ion binding and extracellular matrix. Protein-protein interaction analysis showed that these genes, including previously reported genes such as fibronectin, COL2A1 and ?-catenin, may play key roles in disc degeneration. Unsupervised clustering indicated that the widely used morphology-based Thompson grading system was only marginally associated with the molecular classification of intervertebral disc degeneration. These findings indicate that detailed, systematic gene analysis may be a useful way of studying the biology of intervertebral disc degeneration.

Chen, Kai; Wu, Dajiang; Zhu, Xiaodong; Ni, Haijian; Wei, Xianzhao; Mao, Ningfang; Xie, Yang; Niu, Yunfei; Li, Ming

2013-01-01

171

Long-term outcome after implantation of prosthetic disc nucleus device (PDN) in lumbar disc disease  

PubMed Central

Background: The prosthetic disc nucleus (PDN) device offers an adjunct treatment for patients with degenerative disc disease and herniation, who necessitate surgical intervention, avoiding total-disc replacement or fusion. This prospective, clinical study aimed to gauge the long-term effectiveness of microdiscectomy followed by PDN implantation in relieving pain and improving functional status in patients with symptomatic degenerative lumbar disc disease and herniation. Methods: Ten patients with a) at least 6 months low back pain and/or sciatica resistant to conservative treatment and b) radiologically documented degenerative lumbar disc disease and herniation have been selected. Follow-up at 6 weeks, 3, 12, 48, and 96 months postoperatively included physical examination, radiological investigation (plain and dynamic radiographs and magnetic resonance imaging), and self-completion of outcome scales (visual analogue, Oswestry, and Prolo functional status). Short Form-36 version 2 Health Survey patient profile at 96 months completed the image of health related quality of life. Results: Patients' mean follow-up was 100.6 months. Significant improvements in Oswestry, Prolo, and VAS scores were documented (p: 0.004 in all scales at 48 months). Generic health status was rated within the average lumbar disease population (46.36.8 for physical component summary and 45.29.6 for mental component summary). Lumbar spine range of motion (20.211.8 at 96 months) was restricted in relation to normal, but maintained considerable mobility. Treated disc height increased postoperatively (p:0.002) and its maintenance could also be documented in all cases. Disc height at the level above did not show any significant modification. All postoperative MRI showed a non-clinically significant high signal of end-plate on T2 sequences. Clinically relevant complications included one case of pulmonary thrombosis and one case of device extrusion, which was subsequently explanted. Conclusions: After implantation, most patients continue to enjoy significant pain relief, a considerable amount of mobility is conserved and the disease specific functional outcome is excellent and remains for long, although it could not be supported that the generic health related quality of life is that of the general population.

Selviaridis, P; Foroglou, N; Tsitlakidis, A; Hatzisotiriou, A; Magras, I; Patsalas, I

2010-01-01

172

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

Microsoft Academic Search

This report reviews 36 patients aged 71 to 93 years who had lumbar spinal surgey 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

Alpaslan Kulali; Klaus von Wild

1996-01-01

173

Cardiac herniation following completion pneumonectomy for bronchiectasis.  

PubMed

Sporadic reports on cardiac herniation are available in the literature; most of them had followed intrapericardial pneumonectomies for malignant pulmonary tumors. We present an uncommon event of heart herniation after a completion pneumonectomy indicated for chronic bronchiectasis. A 35-year-old male patient was operated for left completion pneumonectomy. A 6 cm x 4 cm area of adherent pericardium near the obtuse margin of heart was removed during surgery. During head-end elevation of the bed in postoperative intensive care unit, patient got accidentally tilted to the left side, which resulted in ventricular fibrillation. Chest cavity was re-opened for cardiopulmonary resuscitation. Left ventricle was found herniating through the pericardial deficiency into the left-thoracic cavity with the cardiac apex touching chest wall. During surgical re-exploration, the pericardial deficiency was closed with a synthetic Dacron patch. Hemodynamic condition remained stable in the immediate postoperative period. Patients had infection of the left thoracic cavity after 5 weeks, for which he was subjected to thoracoplasty and omentopexy. Prompt recognition with timely intervention is life saving from cardiac herniation. Strategy of closing the pericardial defect after pneumonectomy should be followed routinely, irrespective of the indication for pneumonectomy. PMID:20826968

Gadhinglajkar, Shrinivas; Siddappa, Shivananda; Sreedhar, Rupa; Madathipat, Unnikrishnan

174

Evidence for an Inherited Predisposition to Lumbar Disc Disease  

PubMed Central

Background: A genetic predisposition for the development of symptomatic lumbar disc disease has been suggested by several twin sibling studies and subsequent genetic marker studies. The purpose of the present study was to define population-based familial clustering among individuals with a diagnosis of, or treated for, lumbar disc herniation or disc degeneration. Methods: The Utah Population Database allows analysis of combined health and genealogic data for over one million Utah residents. We used the International Classification of Diseases, Ninth Revision, diagnosis codes entered in patient records to identify patients with a diagnosis of either lumbar disc herniation or lumbar disc degeneration and genealogic data. The hypothesis of excess relatedness (familial clustering) was tested with use of the Genealogical Index of Familiality, which compares the average relatedness of affected individuals with expected population relatedness. Relative risks in relatives were estimated by comparing rates of disease in relatives with expected population rates (estimated from the relatives of matched controls). This methodology has been previously reported for other disease conditions but not for spinal diseases. Results: The Genealogical Index of Familiality test for 1264 patients with lumbar disc disease showed a significant excess relatedness (p < 0.001). Relative risk in relatives was significantly elevated in both first-degree (relative risk, 4.15; p < 0.001) and third-degree relatives (relative risk, 1.46; p = 0.027). Conclusions: Excess relatedness of affected individuals and elevated risks to both near and distant relatives was observed, strongly supporting a heritable contribution to the development of symptomatic lumbar disc disease. Level of Evidence: Prognostic Level II. See Instructions to Authors for a complete description of levels of evidence.

Patel, Alpesh A.; Spiker, William Ryan; Daubs, Michael; Brodke, Darrel; Cannon-Albright, Lisa A.

2011-01-01

175

Standards of Practice: Quality Assurance Guidelines for Percutaneous Treatments of Intervertebral Discs  

SciTech Connect

Percutaneous treatments are used in the therapy of small- to medium-sized hernias of intervertebral discs to reduce the intradiscal pressure in the nucleus and theoretically create space for the herniated fragment to implode inward, thus reducing pain and improving mobility and quality of life. These techniques involve the percutaneous removal of the nucleus pulposus by using a variety of chemical, thermal, or mechanical techniques and consist of removal of all or part of nucleus pulposus to induce more rapid healing of the abnormal lumbar disc. These guidelines are written to be used in quality improvement programs for assessing fluoroscopy- and/or computed tomography-guided percutaneous intervertebral disc ablative techniques.

Kelekis, Alexis D., E-mail: akelekis@med.uoa.gr; Filippiadis, Dimitris K., E-mail: dfilippiadis@yahoo.g [Attikon University Hospital, 2nd Radiology Department (Greece); Martin, Jean-Baptiste, E-mail: jbmartin@cird.c [Geneva University Hospital, Service d'Imagerie Medicale (Switzerland); Brountzos, Elias, E-mail: ebrountz@med.uoa.g [Attikon University Hospital, 2nd Radiology Department (Greece)

2010-10-15

176

Cervical myelopathy due to nuclear herniations in young adults: clinical and radiological profile, results of microdiscectomy without interbody fusion.  

PubMed Central

A study was made of the clinical and radiological characteristics and the results of microsurgical discectomy without interbody fusion, of 26 young adults, who presented with cervical myelopathy due to nuclear herniations. Neck trauma was not a significant aetiological factor. The disease produced moderate to very severe functional disability in most patients (73%), in a relatively short period (mean symptom duration 6.3 months). Radiological assessment revealed the presence of canal stenosis, significant disc protrusions with paucity of spondylotic changes in most patients. At operation, soft disc lesions were found in 85% and sequestrated discs in 31%. Microsurgical discectomy without fusion produced gratifying recovery of functional disability without significant deleterious effects on the cervical spine. Images

Selladurai, B M

1992-01-01

177

Immune cascades in human intervertebral disc: the pros and cons  

PubMed Central

The unique structural hallmark of the intervertebral disc has made its central composition, the nucleus pulposus (NP), excluded from the immunologic tolerance. Consequently, the intervertebral disc is identified as an immune-privileged organ. Traditionally, local detrimental immune activities caused by NP at the lesion sites of the disc are noted as a significant factor contributing to disc degeneration. However, given the beneficial activities of immune cells in other immune-privileged sites on basis of current evidence, the degenerate disc might need the assistance of a subpopulation of immune cells to restore its structure and lessen inflammation. In addition, the beneficial impact of immune cells can be seen in the absorption of the herniated NP, which is an important factor causes the mechanical compression of nerve roots. Consequently, a modulated immune network in degenerate disc is essential for the restoration of this immune-privileged organ. Until now, the understandings of immune response in disc degeneration still rest on the harmful aspect. Further studies are needed to explore its beneficial influence. Accordingly, there are no absolutely the pros and cons in terms of immune reactions caused by NP.

Sun, Zhen; Zhang, Ming; Zhao, Xu-Hong; Liu, Zhi-Heng; Gao, Yang; Samartzis, Dino; Wang, Hai-Qiang; Luo, Zhuo-Jing

2013-01-01

178

D-Zero Cryostat Supplemental Rupture Disc  

SciTech Connect

The common relief and rupture disc vent line requires a double disc assembly with vented interspace for accurate disc burst pressures. The first disc must take pump and purge vacuum loading, but be set to operate at 110% of the MAWP, 18.3 psig (ASME code). The available solution is 18.3 psig with a burst tolerance of +/- psig. The interspace should be locally vented by a flow limiting vent valve to decouple the vent line backpressure from the vessel rupture disc. The second disc must take the worst case vent line backpressure, the steady state value found in D-Zero engineering note 3740.000-EN-63 with all three cryostats simultaneously venting at the fire condition into the 4-inch x 6-inch and 6-inch x 8-inch sections. This value is less than 2 psid. The maximum rupture value for the second disc must be less than the minimum rupture value for the first disc less 2 psid i.e. < 16.3.

Mulholland, G.T.; /Fermilab

1987-08-03

179

Cervical myelopathy due to single level prolapsed disc and spondylosis: a comparative study on outcome between two groups  

Microsoft Academic Search

This article describes a retrospective study on myelopathy, induced by monosegmental prolapsed disc and spondylosis. To assess\\u000a pre- and postoperative clinical and radiological findings related to myelopathy, and factors influencing the outcome, 20 disc\\u000a herniation (group A) and 11 spondylosis patients (group B) were studied. Average duration of myelopathy in groups A and B\\u000a were 3 and 8.7 months, respectively. Anterior

Jong-Seon Ryu; Jong-Woo Chae; Woo-Jin Cho; Han Chang; Myung-Sang Moon; Sung-Soo Kim

2010-01-01

180

Breathing patterns in children with craniofacial dysostosis and hindbrain herniation  

Microsoft Academic Search

In the past few years, hindbrain herniation has become recognized as a frequent feature of the child with syndromic craniofacial dysostosis. The clinical sig- nificance of hindbrain herniation in these disorders is unclear. Abnormalities of respi- ratory control have frequently been reported. The aim of the present study was to document the incidence of obstructive and central respiratory abnormalities during

S. L. Gonsalez; D. Thompson; R. Hayward

1998-01-01

181

Lung herniation: a rare complication in minimally invasive cardiothoracic surgery  

Microsoft Academic Search

Objective: Lung herniation, defined as a protrusion of the lung parenchyma with pleural membranes through a defect of the thoracic wall, is a rare entity. As minimally invasive cardiac procedures evolve, different complications may be evident such as lung herniation. A retrospective review of all patients submitted to minimally invasive cardiac or transplant surgery through anterior mini-thoracotomy at our department

Kalliopi Athanassiadi; Erik Bagaev; Andre Simon; Axel Haverich

2008-01-01

182

Lung herniation: a rare complication in minimally invasive cardiothoracic surgery  

Microsoft Academic Search

Objective: Lung herniation, defined as a protrusion of the lung parenchyma with pleural membranes through a defect of the thoracic wall, is a rare entity. As minimally invasive cardiac procedures evolve, different complications may be evident such as lung herniation. A retrospective review of all patients submitted to minimally invasive cardiac or transplant surgery through anterior mini-thoracotomy at our department

Kalliopi Athanassiadi; Erik Bagaev; Andre Simon; Axel Haverich

2010-01-01

183

Higher risk of dural tears and recurrent herniation with lumbar micro-endoscopic discectomy.  

PubMed

Existing studies on micro-endoscopic lumbar discectomy report similar outcomes to those of open and microdiscectomy and conflicting results on complications. We designed a randomised controlled trial to investigate the hypothesis of different outcomes and complications obtainable with the three techniques. 240 patients aged 18-65 years affected by posterior lumbar disc herniation and symptoms lasting over 6 weeks of conservative management were randomised to micro-endoscopic (group 1), micro (group 2) or open (group 3) discectomy. Exclusion criteria were less than 6 weeks of pain duration, cauda equina compromise, foraminal or extra-foraminal herniations, spinal stenosis, malignancy, previous spinal surgery, spinal deformity, concurrent infection and rheumatic disease. Surgery and follow-up were made at a single Institution. A biomedical researcher independently collected and reviewed the data. ODI, back and leg VAS and SF-36 were the outcome measures used preoperatively, postoperatively and at 6-, 12- and 24-month follow-up. 212/240 (91%) patients completed the 24-month follow-up period. VAS back and leg, ODI and SF36 scores showed clinically and statistically significant improvements within groups without significant difference among groups throughout follow-up. Dural tears, root injuries and recurrent herniations were significantly more common in group 1. Wound infections were similar in group 2 and 3, but did not affect patients in group 1. Overall costs were significantly higher in group 1 and lower in group 3. In conclusion, outcome measures are equivalent 2 years following lumbar discectomy with micro-endoscopy, microscopy or open technique, but severe complications are more likely and costs higher with micro-endoscopy. PMID:20127495

Teli, Marco; Lovi, Alessio; Brayda-Bruno, Marco; Zagra, Antonino; Corriero, Andrea; Giudici, Fabrizio; Minoia, Leone

2010-02-03

184

Higher risk of dural tears and recurrent herniation with lumbar micro-endoscopic discectomy  

PubMed Central

Existing studies on micro-endoscopic lumbar discectomy report similar outcomes to those of open and microdiscectomy and conflicting results on complications. We designed a randomised controlled trial to investigate the hypothesis of different outcomes and complications obtainable with the three techniques. 240 patients aged 18–65 years affected by posterior lumbar disc herniation and symptoms lasting over 6 weeks of conservative management were randomised to micro-endoscopic (group 1), micro (group 2) or open (group 3) discectomy. Exclusion criteria were less than 6 weeks of pain duration, cauda equina compromise, foraminal or extra-foraminal herniations, spinal stenosis, malignancy, previous spinal surgery, spinal deformity, concurrent infection and rheumatic disease. Surgery and follow-up were made at a single Institution. A biomedical researcher independently collected and reviewed the data. ODI, back and leg VAS and SF-36 were the outcome measures used preoperatively, postoperatively and at 6-, 12- and 24-month follow-up. 212/240 (91%) patients completed the 24-month follow-up period. VAS back and leg, ODI and SF36 scores showed clinically and statistically significant improvements within groups without significant difference among groups throughout follow-up. Dural tears, root injuries and recurrent herniations were significantly more common in group 1. Wound infections were similar in group 2 and 3, but did not affect patients in group 1. Overall costs were significantly higher in group 1 and lower in group 3. In conclusion, outcome measures are equivalent 2 years following lumbar discectomy with micro-endoscopy, microscopy or open technique, but severe complications are more likely and costs higher with micro-endoscopy.

Lovi, Alessio; Brayda-Bruno, Marco; Zagra, Antonino; Corriero, Andrea; Giudici, Fabrizio; Minoia, Leone

2010-01-01

185

Herpes virus infection can cause intervertebral disc degeneration: a causal relationship?  

PubMed

It has been proposed that intervertebral disc degeneration might be caused by low-grade infection. The purpose of the present study was to assess the incidence of herpes viruses in intervertebral disc specimens from patients with lumbar disc herniation. A polymerase chain reaction based assay was applied to screen for the DNA of eight different herpes viruses in 16 patients and two controls. DNA of at least one herpes virus was detected in 13 specimens (81.25%). Herpes Simplex Virus type-1 (HSV-1) was the most frequently detected virus (56.25%), followed by Cytomegalovirus (CMV) (37.5%). In two patients, co-infection by both HSV-1 and CMV was detected. All samples, including the control specimens, were negative for Herpes Simplex Virus type-2, Varicella Zoster Virus, Epstein Barr Virus, Human Herpes Viruses 6, 7 and 8. The absence of an acute infection was confirmed both at the serological and mRNA level. To our knowledge this is the first unequivocal evidence of the presence of herpes virus DNA in intervertebral disc specimens of patients with lumbar disc herniation suggesting the potential role of herpes viruses as a contributing factor to the pathogenesis of degenerative disc disease. PMID:21911538

Alpantaki, K; Katonis, P; Hadjipavlou, A G; Spandidos, D A; Sourvinos, G

2011-09-01

186

Dynamics of Astrophysical Discs  

NASA Astrophysics Data System (ADS)

Preface; Names and addresses of participants; Conference photograph; 1. Spiral waves in Saturn's rings; 2. Structure of the Uranian rings; 3. Planetary rings: theory; 4. Simulations of light scattering in planetary rings; 5. Accretion discs around young stellar objects and the proto-Sun; 6. The ß Pictoris disc: a planetary rather than a protoplanetary one; 7. Optical polarimetry and thermal imaging of the disc axound ß Pictoris; 8. Observations of discs around protostars and young stars; 9. VLA observations of ammonia towaxd moleculax outflow sources; 10. Derivation of the physical properties of molecular discs by an MEM method; 11. Masers associated with discs around young stars; 12. The nature of polarisation discs axound young stars; 13. The correlation between the main parameters of the interstellar gas (including Salpeter's spectrum of masses) as a result of the development of turbulent Rossby waves; 14. Discs in cataclysmic variables and X-ray binaries; 15. A disc instability model for soft X-ray transients containing black holes; 16. X-ray variability from the accretion disc of NGC 5548; 17. Viscously heated coronae and winds around accretion discs; 18. Optical emission line profiles of symbiotic stars; 19. The effect of formation of Fell in winds confined to discs for luminous stars; 20. Observational evidence for accretion discs in active galactic nuclei; 21. The fuelling of active galactic nuclei by non-axisynlinetric instabilities; 22. The circum-nuclear disc in the Galactic centre; 23. Non-axisymmetric instabilities in thin self-gravitating differentially rotating gaseous discs; 24. Non-linear evolution of non-axisymmetric perturbations in thin self-gravitating gaseous discs; 25. Eccentric gravitational instabilities in nearly Keplerian discs; 26. Gravity mode instabilities in accretion tori; 27. The stability of viscous supersonic shear flows - critical Reynolds numbers and their implications for accretion discs; 28. Asymptotic analysis of overstable convective modes of uniformly rotating stars; 29. Polytropic models in very rapid rotation; 30. Distribution and kinematics of gas in galaxy discs; 31. Are the smallest galaxies optically invisible?; 32. Can we understand the constancy of rotation curves?; 33. How well do we know the surface density of the Galactic disc?; 34. On the heating of the Galactic disc; 35. The bulge-disc interaction in galactic centres; 36. Dynamics of the large-scale disc in NGC 1068; 37. The flow of gas in barred galaxies; 38. The warped dust lane in A1029-459; 39. Structure and evolution of dissipative non-planar galactic discs; 40. Non-axisymmetric magnetic fields in turbulent gas discs; 41. Non-axisymmetric disturbances in galactic discs; 42. Spiral instabilities in N-body simulations; 43. Long-lived spiral waves in N-body simulations; 44. Overstable modes in stellar disc systems; 45. Galactic seismological approach to the spiral galaxy NGC 3198; 46. Characteristics of bars from 3-1) simulations; 47. Spirals and bars in linear theory; 48. Stellar hydrodynamical solutions for Eddington discs; 49. Theory of gradient instabilities of the gaseous Galactic disc and rotating shallow water; 50. Stability criteria for gravitating discs; 51. Stability of two-component galactic discs; 52. The smoothed particle hydrodynamics of galactic discs; 53. Tidal triggering of active disc galaxies by rich clusters; 54. The formation of spiral arms in early stages of galaxy interaction; 55. Formation of leading spiral arms in retrograde galaxy encounters; 56. The influence of galaxy interactions on stellar bars; 57. Disc galaxies - work in progress in Gothenburg; 58. Motion of a satellite in a disc potential; 59. Observer's summary; 60. Common processes and problems in disc dynamics; Citation index; Index of authors; Subject index.

Sellwood, J. A.

2004-01-01

187

Disc protrusion in the childParticular features and comparison with neoplasms  

Microsoft Academic Search

Lumbar intervertebral disc herniation, although common in adults, is infrequent in the young, and especially in patients\\u000a under 17 years old. In this work we review clinical data pertaining to two pediatric groups of patients whose main complaint\\u000a was low back pain and\\/or sciatica, trying to identify factors that might contribute to their earlier referral and to the differential\\u000a diagnosis

Juan F. Martínez-Lage; Antonio Martínez-Robledo; Francisco López; Máximo Poza

1997-01-01

188

Artificial Disc Replacement  

MedlinePLUS

... and a replacement device is implanted into the space between the vertebra. With a disc nucleus replacement, only the center of the disc (the nucleus) is removed and replaced with an implant. The outer part of the disc (the annulus) is not ...

189

Automotive disc brake squeal  

Microsoft Academic Search

Disc brake squeal remains an elusive problem in the automotive industry. Since the early 20th century, many investigators have examined the problem with experimental, analytical, and computational techniques, but there is as yet no method to completely suppress disc brake squeal. This paper provides a comprehensive review and bibliography of works on disc brake squeal. In an effort to make

N. M. Kinkaid; O. M. O'Reilly; P. Papadopoulos

2003-01-01

190

CT-guided percutaneous laser disc decompression with Ceralas D, a diode laser with 980-nm wavelength and 200-?m fiber optics  

Microsoft Academic Search

.   The aim of this study was to evaluate the compact, portable Ceralas-D diode laser (CeramOptec; 980 + 30 nm wavelength, 200-?m\\u000a optical fiber) concerning clinical usefulness, handling, and clinical results in the CT-guided treatment of herniated lumbar\\u000a discs. The positioning of the canula in intradiscal space, the placement of the laser fiber into the disc through the lying\\u000a canula,

A. Gevargez; D. W. H. Groenemeyer; F. Czerwinski

2000-01-01

191

Intervertebral disc segmentation and volumetric reconstruction from peripheral quantitative computed tomography imaging.  

PubMed

An automatic system for segmenting and constructing volumetric representations of excised intervertebral discs from peripheral quantitative computed tomography (PQCT) imagery is presented. The system is designed to allow for automatic quantitative analysis of progressive herniation damage to the intervertebral discs under flexion/extension motions combined with a compressive load. Automatic segmentation and volumetric reconstruction of intervertebral disc from PQCT imagery is a very challenging problem due to factors such as streak artifacts and unclear material density separation between contrasted intervertebral disc and surrounding bone in the PQCT imagery, as well as the formation of multiple contrasted regions under axial scans. To address these factors, a novel multiscale level set approach based on the Mumford-Shah energy functional in iterative bilateral scale space is employed to segment the intervertebral disc regions from the PQCT imagery. A Delaunay triangulation is then performed based on the set of points associated with the intervertebral disc regions to construct the volumetric representation of the intervertebral disc. Experimental results show that the proposed system achieves segmentation and volumetric reconstructions of intervertebral discs with mean absolute distance error below 0.8 mm when compared to ground truth measurements. The proposed system is currently in operational use as a visualization tool for studying progressive intervertebral disc damage. PMID:19635691

Wong, Alexander; Mishra, Akshaya; Yates, Justin; Fieguth, Paul; Clausi, David A; Callaghan, Jack P

2009-07-24

192

Strain in fibers of a lumbar disc. Analysis of the role of lifting in producing disc prolapse.  

PubMed

A three-dimensional nonlinear finite element model has been used to predict the strain in the disc fibers of a lumbar motion segment under various single and combined loads such as those representing symmetric and non-symmetric liftings. A progressive failure analysis also has been performed under loads representing lifting while bending to one side: assuming yield and ultimate fiber strains of 14 and 16%, respectively. Large tensile strains of about 10% in the disc fibers are predicted under the maximum loads simulating symmetric lifting. Addition of lateral bending and twisting significantly increases the maximum fiber strain to more than 20%, and hence augments the risk for disc rupture. The maximum fiber strain occurs in the innermost annulus layer at the posterolateral location. Loss of intradiscal pressure or volume has a marked diminishing effect on the magnitude of maximum fiber strain predicted under flexion loadings. Failure analysis indicates that rupture initiates in the fibers in the innermost layer at the posterolateral location. With a slight increase in the loads, rupture progresses radially to the adjacent outer layer. Further progress of rupture in the fibers toward the annulus outer periphery resulting in complete radial fissure and disc prolapse appears to require additional increase in the loads. In the presence of large intradiscal pressure, the generated partial or complete radial fissure is likely to result in annulus protrusion or disc herniation, respectively. The results of clinical, epidemiologic, and experimental studies support the failure mechanism predicted in the present study. PMID:2913676

Shirazi-Adl, A

1989-01-01

193

Prolapsed intervertebral disc at the upper lumbar level. Diagnostic difficulties. A report on 12 cases.  

PubMed

Prolapsed intervertebral disc at the upper lumbar level causes problems in diagnosis. Compressive root syndromes at L1-L2-L3 present clinical features which are not very specific. They are frequently pluriradicular and may be referred to areas of atypical distribution. The anatomical features and the relationship between discs and nerve roots and any variations are illustrated. Based on our personal experience with 12 cases of herniation of the first two lumbar discs, we would emphasize the importance of extending myelography and CT scanning to the high lumbar metameres whenever the symptomatology is equivocal. If such a policy were adopted, the incidence of prolapsed disc at the higher lumbar levels would probably be found to be higher than is at present supposed. PMID:3503877

Fontanesi, G; Tartaglia, I; Cavazzuti, A; Giancecchi, F

1987-12-01

194

Anterior discectomy without fusion for treatment of cervical lateral soft disc extrusion: a follow-up of 120 cases.  

PubMed

One hundred and twenty patients with soft lateral disc herniation underwent surgery by anterior microsurgical discectomy and routine ablation of the posterior longitudinal ligament between 1976 and 1986. The study excluded patients with hard discs and soft disc extrusion with medullary symptoms. In our series 76.6% of patients were men. In 64% of the patients no causative factor was found. All of the patients presented with cervicobrachialgia; 53% also had a motor deficit. In 91.7% a single disc was involved. The last 40 cases were evaluated by computed tomography alone. In 51.5% an extruded disc was found. No permanent postoperative complication was encountered. All patients returned to their previous activities. Fifty patients underwent follow-up radiological evaluation at 1 and 5 years after the intervention and vertebral fusion was observed in 70% of these. PMID:2747859

Grisoli, F; Graziani, N; Fabrizi, A P; Peragut, J C; Vincentelli, F; Diaz-Vasquez, P

1989-06-01

195

Functional results and the risk factors of reoperations after lumbar disc surgery.  

PubMed

Factors such as driving motor vehicles, sedentary occupations, vibration, smoking, previous full-term pregnancies, physical inactivity, increased body mass index (BMI), and a tall stature are associated with symptomatic disc herniations. Fitness and strength is postulated to protect an individual from disc rupture. The objective of our study was to determine the pain levels and differences of functional and economic situations of patients who had undergone one or more than one operation due to lumbar disc herniation and to put forward the effect of risk factors that may be potential, especially from the aspect of undergoing reoperation. Patients who had undergone one (n=46) or more than one operation (n=34) due to lumbar disc herniation were included in the study. It was a prospective study with evaluation on the day the patients were discharged and at second and sixth months after lumbar disc operation. The Oswestry Disability Index (ODI) was used in determining the functional disability associated with back pain; the Prolo Functional Economic Rating Scale (Prolo scale) was used in determining the effect of back pain on functional and economic situations. In the ODI measurements made in the postoperative second and sixth months, significant differences appeared in favor of patients who had undergone one operation (p<0.05). According to the Prolo scale, it was found that the economic situation was better in the sixth month and the functional situation was better in the second and sixth months in patients having undergone one operation (p<0.05). The logistic regression analysis demonstrated that the lack of regular physical exercise was a significant predictor for reoperation (OR, 4.595; CI, 1.38-15.28), whereas gender, age, BMI, occupation, or smoking did not indicate so much significance as regular exercise. PMID:15490256

Kara, Bilge; Tulum, Zeliha; Acar, Umit

2004-10-13

196

Genes associated with disc degeneration identified using microarray gene expression profiling and bioinformatics analysis.  

PubMed

Disc degeneration is strongly associated with back or neck pain, sciatica, and disc herniation or prolapse. It places an enormous economic burden on society and can greatly affect quality of life. Alternative treatment approaches, such as genetic therapies, are urgently needed to slow or reverse the disc degeneration process. We downloaded gene expression data from Gene Expression Omnibus during various stages of disc degeneration and identified differentially expressed genes (DEGs) as well as dysfunctional pathways through comparisons with controls. We identified 2 significant DEGs between grade II and III discs and 8 significant DEGs between grade II and IV discs. By constructing an interactive network of the DEGs, we found that mitogen-activated protein family genes and Ras homologous (Rho) family genes - in particular, MAP2K6 and RHOBTB2 - may play important roles in the progression of degeneration of grade III and IV discs, respectively. MAP2K6 and RHOBTB2 may be specific therapeutic molecular targets in the treatment of disc degeneration. However, further experiments are needed to confirm this result. PMID:23661466

Chen, Y; Chen, K; Li, M; Li, C; Ma, H; Bai, Y S; Zhu, X D; Fu, Q

2013-04-26

197

VACUUM TRAP  

DOEpatents

An improved adsorption vacuum trap for use in vacuum systems was designed. The distinguishing feature is the placement of a plurality of torsionally deformed metallic fins within a vacuum jacket extending from the walls to the central axis so that substantially all gas molecules pass through the jacket will impinge upon the fin surfaces. T fins are heated by direct metallic conduction, thereby ol taining a uniform temperature at the adeorbing surfaces so that essentially all of the condensible impurities from the evacuating gas are removed from the vacuum system.

Gordon, H.S.

1959-09-15

198

Vacuum Technology  

SciTech Connect

The environmental condition called vacuum is created any time the pressure of a gas is reduced compared to atmospheric pressure. On earth we typically create a vacuum by connecting a pump capable of moving gas to a relatively leak free vessel. Through operation of the gas pump the number of gas molecules per unit volume is decreased within the vessel. As soon as one creates a vacuum natural forces (in this case entropy) work to restore equilibrium pressure; the practical effect of this is that gas molecules attempt to enter the evacuated space by any means possible. It is useful to think of vacuum in terms of a gas at a pressure below atmospheric pressure. In even the best vacuum vessels ever created there are approximately 3,500,000 molecules of gas per cubic meter of volume remaining inside the vessel. The lowest pressure environment known is in interstellar space where there are approximately four molecules of gas per cubic meter. Researchers are currently developing vacuum technology components (pumps, gauges, valves, etc.) using micro electro mechanical systems (MEMS) technology. Miniature vacuum components and systems will open the possibility for significant savings in energy cost and will open the doors to advances in electronics, manufacturing and semiconductor fabrication. In conclusion, an understanding of the basic principles of vacuum technology as presented in this summary is essential for the successful execution of all projects that involve vacuum technology. Using the principles described above, a practitioner of vacuum technology can design a vacuum system that will achieve the project requirements.

Biltoft, P J

2004-10-15

199

Outcomes of cervical and lumbar disk herniations in Major League Baseball pitchers.  

PubMed

The effects of disk herniations on the career and performance outcomes of Major League Baseball (MLB) pitchers are unknown. The purpose of this study is to determine the outcomes after a cervical or lumbar disk herniation for MLB pitchers. Forty MLB pitchers from 1984 to 2009 with a cervical disk herniation or lumbar disk herniation were identified using a previously established protocol. Cervical disk herniation was identified in 11 pitchers, 8 of which were treated operatively. The majority of pitchers with cervical disk herniation (8/11) returned to play at an average of 11.6 months. Lumbar disk herniation was identified in 29 pitchers, 20 of which were treated operatively. All pitchers with lumbar disk herniation (29/29) returned to play at an average of 7.3 months after diagnosis. PMID:21800814

Roberts, David W; Roc, Gilbert J; Hsu, Wellington K

2011-08-01

200

[Diaphragmatic herniation after oesophagectomy: a report of two cases].  

PubMed

Diaphragmatic herniation is the protrusion of abdominal structures into the chest through a defect in the diaphragm. It is a rare complication following oesophagectomy. Preoperative diagnosis is important in order to establish both the nature and extent of the diaphragmatic defect. The treatment of choice is surgery. In a series of 574 intrathoracic oesophagogastroplasties performed at our Institution from 1990 to 2004, the prevalence of diaphragmatic herniation was 0.35%. We report two cases of major diaphragmatic herniation after oesophagectomy for cancer performed using a laparotomic-thoracotomic (case 1) and a laparoscopicthoracotomic approach (case 2). The case 1 patient was asymptomatic: hernia repair involved hiatoplasty and mesh positioning. The case 2 patient presented with vomiting and abdominal pain: she underwent emergency laparoscopic surgery and direct closure of the diaphragmatic tear. At 12 months' follow-up, both patients were symptom-free. A barium swallow confirmed that the previously herniated abdominal viscera had returned to the abdomen. Diaphragmatic herniation following oesophagectomy is a rare complication which may be asymptomatic or present as bowel obstruction. Several aetiopathogenetic factors may be responsible for diaphragmatic hernias: enlargement of the diaphragmatic hiatus, a combination of negative pressure in the chest and positive pressure in the abdomen, and small number of adhesions in the case of patients operated on with minimally invasive surgery. Surgical repair is the treatment of choice and is mandatory as emergency treatment in the case of symptomatic hernias. PMID:17663385

Rampado, Sabrina; Zaninotto, Giovanni; Fiore, Davide; Ruol, Albero; Castoro, Carlo; Portale, Giuseppe; Ancona, Ermanno

201

Efficacy of lumbar discectomy and percutaneous treatments for lumbar disc herniation  

Microsoft Academic Search

Summary The changing health care environment necessitates careful re-evaluation of all costly elective procedures. Low back surgery is a typical example. This article reviews the current literature addressing the efficacy of surgery and invasive percutaneous treatments for discogenic sciatica. It also discusses the prospects for the continuation of reimbursement for these procedures under a system of managed health care. Relevant

Carl D. Stevens; Robert W. Dubois; Tania Larequi-Lauber; John-Paul Vader

1997-01-01

202

Disc-like herniation in association with gas collection in the spinal canal: CT evaluation  

Microsoft Academic Search

Gas production as a part of disk degeneration can occur but rarely causes nerve compression syndromes. Few cases have been reported in which lumbar intraspinal epidural gas cause nerve root compression symptoms. We present 12 cases of gas collection in the spinal canal that were presented to the orthopaedic out-patient department with symptoms of low back pain and sciatica. CT

Ioannis Tsitouridis; Fares E. Sayegh; Panagiota Papapostolou; Stella Chondromatidou; Fotini Goutsaridou; Maria Emmanouilidou; Maria S. Sidiropoulou; George A. Kapetanos

2005-01-01

203

Spontaneous intracranial hypotension due to intradural thoracic osteophyte with superimposed disc herniation: report of two cases  

Microsoft Academic Search

Spontaneous intracranial hypotension (SIH) is a clinical syndrome in which absolute or relative hypovolemia of the cerebrospinal\\u000a fluid (CSF) results in various neurological symptoms. The etiology of spontaneous CSF leaks often remains unknown. However,\\u000a it is believed that the most common cause is the fragility of spinal meninges at the level of radicular nerve root sleeve.\\u000a These tears can be

Zehra Isik Hasiloglu; Bashar Abuzayed; Ahmet Esat Imal; Emin Cagil; Sait Albayram

204

Comparative immunohistochemical study of group II (synovial-type) and group IV (cytosolic) phospholipases A 2 in disc prolapse tissue  

Microsoft Academic Search

Phospholipase A2 (PLA2) has been suggested to be present in herniated disc tissue and it could possibly be involved in sciatica\\/ discogenic\\u000a back pain mechanisms. In the present study the occurrence of two different phospholipase A2 enzymes, (1) low molecular weight (14 kDa) group II synovial-type (sPLA2) and (2) high molecular weight (85 kDa) group IV\\u000a cytosolic (cPLA2), were compared.

A. Habtemariam; M. Grönblad; J. Virri; O. Airaksinen; M. Luukkonen; V. Turunen; S. Savolainen; E. Karaharju

1998-01-01

205

Intraspinal Extradural Cysts Communicating with Adjacent Herniated Disks: Imaging Characteristics and Possible Pathogenesis  

Microsoft Academic Search

Summary: We report two cases of intraspinal extradural cysts communicating with an adjacent herniated disk that we term ''disk cysts.'' These cysts were well defined and homogeneous, and were present in the ventrolateral ex- tradural space adjacent to a lumbar herniated disk. They had rim enhancement on contrast-enhanced MR images, and communication with a herniated disk was revealed by diskography.

Kinuko Kono; Hiroaki Nakamura; Yuichi Inoue; Terue Okamura; Miyuki Shakudo; Ryusaku Yamada

206

Treatment of a symptomatic forearm muscle herniation with a mesh graft.  

PubMed

Symptomatic muscle herniations are an unusual cause of upper extremity pain in the athlete that is rarely reported in the literature. Out of 18 reported cases of upper extremity herniations, only 3 were caused by strenuous exertion. This article describes a successful repair of a 21-year-old rock climber's ventral forearm herniation with polypropylene mesh. PMID:23016006

Sanders, Brett S; Bruce, Jeremy; Robertson, Jason

2011-03-01

207

Percutaneous Laser Disc Decompression (PLDD): Experience and Results From Multiple Centers and 19,880 Procedures  

NASA Astrophysics Data System (ADS)

In mid-February 1986, Peter Ascher and Daniel Choy performed the first Percutaneous Laser Disc Decompression (PLDD) at the Neurosurgical Department, University of Graz, Graz, Austria. It was planned to deliver 1000 joules with a Nd:YAG laser to a herniated L4-5 disc causing sciatica. At 600 joules the procedure was terminated because the pain was gone. Since then, PLDD has spread all over the world, with procedures being performed in the entire spine except for T1-T4 because these discs do not permit percutaneous access with a needle. The success rate has ranged from 70 to 89%, and the complication rate, chiefly discitis, from 0.3 to 1.0%. When successful, return to normal work averages one week. Long term follow-up to 23 years yields a recurrence rate of 4-5%.

Paolo Tassi, Gian; Choy, Daniel S. J.; Hellinger, Johannes; Hellinger, Stefan; Lee, Sang-Ho

2010-05-01

208

Holographic optical disc  

NASA Astrophysics Data System (ADS)

The holographic disc is a high capacity, disk-based data storage device that can provide the performance for next generation mass data storage needs. With a projected capacity approaching 1 terabit on a single 12 cm platter, the holographic disc has the potential to become a highly efficient storage hardware for data warehousing applications. The high readout rate of holographic disc makes it especially suitable for generating multiple, high bandwidth data streams such as required for network server computers. Multimedia applications such as interactive video and HDTV can also potentially benefit from the high capacity and fast data access of holographic memory.

Zhou, Gan; An, Xin; Pu, Allen; Psaltis, Demetri; Mok, Fai H.

1999-11-01

209

Percutaneous endoscopic transforaminal approach to decompress the lateral recess in an elderly patient with spinal canal stenosis, herniated nucleus pulposus and pulmonary comorbidities.  

PubMed

A 70-year-old man with severe pulmonary comorbidities was referred to our institution for treatment of a right L5 nerve impingement. He had suffered from spinal canal stenosis and herniated nucleus pulposus (HNP) at the level of L4-L5 for more than a year and had been treated conservatively. However, the pain could not be alleviated, and his primary care physician scheduled posterior decompression surgery. During this procedure, the anesthesiologist refused to induce general anesthesia because of the patient's very poor pulmonary condition. Subsequently, the patient was referred to us. We used a transforaminal approach with percutaneous endoscopic discectomy, with the patient under local anesthesia. First, herniated nucleus pulposus fragments at the disc level were removed. With a trephine drill, the upper part of the L5 pedicle was removed, which allowed for the extraction of dorsally migrated fragments. Following complete removal of the herniated nucleus pulposus fragments, osseous decompression was performed. The osseous endplate of L5 (anterior part of the lateral recess) was removed to enlarge the lateral recess so that decompression of the L5 nerve root was possible. The patient's lower back pain and right leg pain subsided following surgery. Percutaneous endoscopic discectomy is useful for patients with severe comorbidities as it can be done with local anesthesia. PMID:23601998

Kitahama, Yoshihiro; Sairyo, Koichi; Dezawa, Akira

2013-05-01

210

Baguera cervical disc prosthesis  

Microsoft Academic Search

A new high performance tool, the disc prosthesis, endows the degenerative cervical rachidian pathology. It allows us to fill\\u000a the fusions’ lacunas by protecting the adjacent levels from an accelerated degeneration while preserving the anatomical and\\u000a physiological characteristics of the cervical spine, especially its mobility. At the present time, there exist several models\\u000a of cervical disc prosthesis on the market.

M. Benmekhbi; J. Mortada; G. Lungu; D. Eichler; R. Srour; J. M. Vital

2008-01-01

211

Paraesophageal herniation as a complication following laparascopic antireflux surgery  

Microsoft Academic Search

Paraesophageal herniation of the stomach is a rare complication following laparoscopic Nissen fundoplication. We retrospectively reviewed our experience with 720 patients undergoing laparoscopic Nissen fundoplications. Seven patients were found to have postoperative paraesophageal hernias requiring reoperation. The clinical presentation, diagnostic workup, operative treatment, and outcome were evaluated. There were no deaths or procedure-related complications. Clinical presentation was recurrent dysphagia in

Matthias H. Seelig; Ronald A. Hinder; Paul J. Klingler; Neil R. Floch; Susan A. Branton; Stephen L. Smith

1999-01-01

212

Brainstem hemorrhage in descending transtentorial herniation (Duret hemorrhage)  

Microsoft Academic Search

Objectives: To review clinical and radiological findings in patients with Duret hemorrhages and to discuss the pathophysiology and differential diagnosis of these lesions. Patients and methods: We reviewed the case records of four patients with Duret hemorrhages who had been admitted to the neurological intensive care unit with supratentorial mass lesions. Results: Descending transtentorial and subfalcine herniations were present in

Paul M. Parizel; Smitha Makkat; Philippe G. Jorens; Özkan Özsarlak; Patrick Cras; Johan W. Van Goethem; Luc van den Hauwe; Jan Verlooy; Arthur M. De Schepper

2002-01-01

213

Diaphragmatic Laceration, Partial Liver Herniation and Catamenial Pneumothorax  

Microsoft Academic Search

Catamenial pneumothorax is a recurrent pneumothorax temporally associated with menstruation. Pathogenesis remains debated however pleural endometriosis or diaphragmatic abnormalities are almost always present. We report the case of a 35-year-old woman with recurrent right catamenial pneumothorax. At thoracoscopy a large laceration of the diaphragm with partial intrathoracic liver herniation was seen. Treatment involved repair of the diaphragmatic lacerations, and pleurodesis.

Antonio Bobbio; Paolo Carbognani; Luca Ampollini; Michele Rusca

214

The role of inflammation in disk herniation-associated radiculopathy  

Microsoft Academic Search

Objective:The causes and physiopathology of low-back pain and acute lumbarradiculopathy remain unclear. A compression of the nerve root by protruded disk has been suggested but explains only partially the physiopathology of radicular pain. This article provides an overview of the role of inflammation in disk herniation-associated radiculopathy.

Philippe Goupille; Malcolm I. V. Jayson; Jean-Pierre Valat; Anthony J. Freemont

1998-01-01

215

Circumplanetary Discs: Truncation and Outbursts  

NASA Astrophysics Data System (ADS)

After a planet with a mass greater than that of Nepture forms it opens a gap in the circumstellar disc. Material continues to flow on to the planet and a circumplanetary disc forms. We model circumplanetary discs as accretion discs subject to the tidal forces of the central star. The tidal torques remove the disc angular momentum near the disc outer edge and permit the accreting disc gas to lose angular momentum at the rate appropriate for steady accretion. Circumplanetary discs are truncated near the radius where periodic ballistic orbits cross, where tidal forces on the disc are strong. This radius occurs at approximately 0.4 times the planet Hill radius. During the T Tauri stage of disc accretion, the disc is fairly thick with aspect ratio H/r>0.2. We model the disc structure using one-dimensional time-dependent and steady-state models and also two-dimensional SPH simulations. The circumplanetary disc structure depends on the variation of the disc turbulent viscosity with radius and is insensitive to the angular distribution of the accreting gas. If the disc is turbulent throughout, the predicted disc structure near the location of the regular Jovian and Saturnian satellites is smooth with no obvious feature that would favor formation at their current locations. Dead zones form in accretion discs where the temperature is too low for the disc to be fully thermally ionised. They are even more favorable in circumplanetary discs than in circumstellar discs because the surface densities are high while the temperature remains low enough to avoid thermal ionisation. We consider the conditions under which dead zones form and the resulting unsteady accretion on to the planet. Outbursts in the accretion rate on to the planet have observational implications for planet detection.

Martin, Rebecca G.; Lubow, S. H.

2011-09-01

216

Bryan total disc arthroplasty: a replacement disc for cervical disc disease  

PubMed Central

Total disc arthroplasty is a new option in the treatment of cervical degenerative disc disease. Several types of cervical disc prostheses currently challenge the gold-standard discectomy and fusion procedures. This review describes the Bryan Cervical Disc System and presents the Bryan prosthesis, its indications, surgical technique, complications, and outcomes, as given in the literature.

Wenger, Markus; Markwalder, Thomas-Marc

2010-01-01

217

Intervertebral disc regeneration or repair with biomaterials and stem cell therapy--feasible or fiction?  

PubMed

The "gold standard" for treatment of intervertebral disc herniations and degenerated discs is still spinal fusion, corresponding to the saying "no disc - no pain". Mechanical prostheses, which are currently implanted, do only have medium outcome success and have relatively high re-operation rates. Here, we discuss some of the biological intervertebral disc replacement approaches, which can be subdivided into at least two classes in accordance to the two different tissue types, the nucleus pulposus (NP) and the annulus fibrosus (AF). On the side of NP replacement hydrogels have been extensively tested in vitro and in vivo. However, these gels are usually a trade-off between cell biocompatibility and load-bearing capacity, hydrogels which fulfill both are still lacking. On the side of AF repair much less is known and the question of the anchoring of implants is still to be addressed. New hope for cell therapy comes from developmental biology investigations on the existence of intervertebral disc progenitor cells, which would be an ideal cell source for cell therapy. Also notochordal cells (remnants of the embryonic notochord) have been recently pushed back into focus since these cells have regenerative potential and can activate disc cells. Growth factor treatment and molecular therapies could be less problematic. The biological solutions for NP and AF replacement are still more fiction than fact. However, tissue engineering just scratched the tip of the iceberg, more satisfying solutions are yet to be added to the biomedical pipeline. PMID:22653467

Chan, Samantha C W; Gantenbein-Ritter, Benjamin

2012-05-31

218

Intradural Migration of a Sequestrated Lumbar Disc Fragment Masquerading as a Spinal Intradural Tumor  

PubMed Central

Intervertebral intradural lumbar disc herniation (ILDH) is a quite rare pathology, and isolated intradural lumbar disc herniation is even more rare. Magnetic resonance imaging (MRI) may not be able to reveal ILDHs, especially if MRI findings show an intact lumbar disc annulus and posterior longitudinal ligament. Here, we present an exceedingly rare case of an isolated IDLH that we initially misidentified as a spinal intradural tumor, in a 54-year-old man hospitalized with a 2-month history of back pain and right sciatica. Neurologic examination revealed a positive straight leg raise test on the right side, but he presented no other sensory, motor, or sphincter disturbances. A gadolinium-enhanced MRI revealed what we believed to be an intradural extramedullary tumor compressing the cauda equina leftward in the thecal sac, at the L2 vertebral level. The patient underwent total L2 laminectomy, and we extirpated the intradural mass under microscopic guidance. Histologic examination of the mass revealed a degenerated nucleus pulposus.

Kim, Hyeong-Suk; Park, Jung-Soo

2012-01-01

219

The accuracy of MRI in the detection of Lumbar Disc Containment  

PubMed Central

Background MRI has proven to be an extremely valuable tool in the assessment of normal and pathological spinal anatomy. Accordingly, it is commonly used to assess containment of discal material by the outer fibers of the anulus fibrosus and posterior longitudinal ligaments. Determination of such containment is important to determine candidacy for intradiscal techniques and has prognostic significance. The accuracy of MRI in detecting containment has been insufficiently documented. Methods The MRI's of fifty consecutive patients undergoing open lumbar microdiscectomy were prospectively evaluated for disc containment by a neuroradiologist and senior spinal surgeon using criteria available in the literature and the classification of Macnab/McCulloch. An independent surgeon then performed the surgery and documented the actual containment status using the same methods. Statistical evaluation of accuracy was undertaken. Results MRI was found to be 72% sensitive, 68% specific, and 70% accurate in detecting containment status of lumbar herniated discs. Conclusion MRI may be inaccurate in assessing containment status of lumbar disc herniations in 30% of cases. Given the importance of containment for patient selection for indirect discectomy techniques and intradiscal therapies, coupled with prognostic significance; other methods to assess containment should be employed to assess containment when such alternative interventions are being considered.

Weiner, Bradley K; Patel, Rikin

2008-01-01

220

Irradiated Accretion Disc Models  

NASA Astrophysics Data System (ADS)

Most of the known accretion discs in binary systems are composed of hydrogen rich material. A few years ago, a new type of binary system was discovered, in which the disc is obviously free of hydrogen and helium. Nowadays six systems are known, with an accretion disc mainly composed of C, O, Ne and Mg (Juett, Psaltis & Chakrabarty 2001; Schulz et al. 2001). The most prominent representative of these ultra compact binary systems is the LMXB 4U 1626-67. The system is consisting of a 7.66 s X-ray pulsar as primary component and a 0.02 solar mass white dwarf as secondary (Chakrabarty 1998). Having a binary separation of only 300 0000 km (Schulz et al. 2001) one can not neglect the external irradiation of the accretion disc by the neutron star. The external irradiation dominates the disc spectrum over a wide range. In the UV one sees emission lines of highly ionised elements, like OV or CIV. One of the biggest numerical problems, occurring during the calculation of an irradiated accretion disc model, is the extreme temperature stratification and structure. This causes severe problems with the occupation numbers of some atomic levels. These problems should be solved by implementing the depth dependent model atom, during my thesis work. During his PhD thesis, Nagel (2003) has developed the numeric code package AcDc. Therewith one can calculate the vertical structure and the emergent synthetic spectrum of an accretion disc. During the work presented here the depth dependent model atom (DEPTOM) was developed and implemented in AcDc as a code module. DEPTOM identifies the trouble making ionisation stages and deactivates them. Thus the calculation is numerically more stable and, hence, makes AcDc more powerful.

Hammer, N. J.

2004-08-01

221

Vacuum Gauges  

NSDL National Science Digital Library

This is a description for a learning module from Maricopa Advanced Technology Education Center. This PDF describes the module; access may be purchased by visiting the MATEC website. Semiconductor manufacturing equipment requires the use of many different types of vacuum gauges. Selection is based on range of process operations and production requirements. This MATEC module explores the theory and functionality of vacuum gauges and provides many examples of different types of gauges. The focus is on understanding the operating ranges and application constraints of each type of gauge. Mathematical equations are used to explain calibration, sensitivity, and overall operations of each type of gauge.

2012-11-28

222

Resolved DEBRIS Discs  

NASA Astrophysics Data System (ADS)

The Herschel DEBRIS survey is a volume-limited survey of 446 of the closest stars at wavelengths of 100 and 160 microns. Excesses at these wavelengths imply the presence of debris discs. Many of these discs were previously imaged with Spitzer but the superior angular resolution of Herschel has allowed us to resolve more than 20 of the largest of these discs. Although similar to the Kuiper belt in our own Solar System, these discs are much more massive and extend much further from their host stars. I will present images for a selection of these systems and discuss what extra information the resolved data can provide about these systems. For instance, the radii measured from the resolved images are shown to be different from that predicted by a black-body fit to the SEDs. This information allows us to infer properties about the size and composition of the dust. Resolved images can also tell us about the planetary system as a whole as the inner edges of these discs are likely to be the result of sculpting by planets. This research is funded through a Space Science Enhancement Program grant from the Canadian Space Agency.

Booth, Mark; DEBRIS Team

2011-09-01

223

Vacuum Technique  

Microsoft Academic Search

Let me say from the beginning that it was a pleasure to peruse this book and I recommend it to researchers and engineers from the field of Cryogenics, both as an introduction and for use in day-to-day work.There are many areas in pure science in which vacuum conditions are required for conducting an experiment, such as solid state physics at

L N Rozanov

2002-01-01

224

Paraesophageal herniation as a complication following laparoscopic antireflux surgery  

Microsoft Academic Search

Paraesophageal herniation of the stomach is a rare complication following laparoscopic Nissen fundoplication. We retrospectively\\u000a reviewed our experience with 720 patients undergoing laparoscopic Nissen fundoplications. Seven patients were found to have\\u000a postoperative paraesophageal hernias requiring reoperation. The clinical presentation, diagnostic workup, operative treatment,\\u000a and outcome were evaluated. There were no deaths or procedure-related complications. Clinical presentation was recurrent dysphagia\\u000a in

Matthias H. Seelig; Ronald A. Hinder; Paul J. Klingler; Neil R. Floch; Susan A. Branton; Stephen L. Smith

1999-01-01

225

Herniation of the bladder after recurrent pubic symphysis diastasis  

Microsoft Academic Search

Bladder and urethral injuries are relatively common complications of pelvic trauma; however, bladder herniation into a pubic\\u000a symphysis diastasis is an unusual sequelae of such trauma. The case reported here is that of a patient in whom the initial\\u000a open-book type fracture of the pelvic ring with a major pubic diastasis was treated with external fixator. Ten weeks after\\u000a satisfactory

William Tabib; Délphine Mitilian; François Pauthier; Eva Ghiles

2010-01-01

226

Herniation through the foramen of Morgagni: early diagnosis and treatment  

Microsoft Academic Search

The majority of congenital diaphragmatic hernias (CDH) occur through the foramen of Bochdalek; herniation through the foramen\\u000a of Morgagni (MH) is rare. Fifteen children (12 males and 3 females) with congenital MH (7 right, 3 left, 5 bilateral) were\\u000a treated over a period of 15 years, comprising 11% of a total of 135 children with different types of CDH. The

Ahmed H. Al-Salem; Akhter Nawaz; Hilal Matta; Alic Jacobsz

2002-01-01

227

A rare complication of aortobifemoral bypass operation: internal herniation.  

PubMed

Intestinal brids are most common cause of postoperative ileus although there are various cause of ileus after abdominal operation. On the other hand internal herniation is a rare cause of ileus after abdominal operations. Diagnosis of this hernias are important because of strangulation and necrosis of its content due to circulatory disturbance. In this case report, we publish a patient with ileus due to a greft which has been used in a previous abdominal surgery for abdominal aort aneurysm. PMID:23599202

Citgez, Bülent; Yetkin, Gürkan; Uluda?, Mehmet; Akgün, Ismail; Ekici, U?ur; Kartal, Abdulcabbar

2013-03-01

228

Radiation from dwarf nova discs.  

NASA Astrophysics Data System (ADS)

The authors use the Shaviv and Wehrse (1991) code to model the vertical structure and the emission properties of quiescent dwarf nova disc. They find that in the case of HT Cas the quiescent disc must be optically thin, in contradiction with the requirements of the standard disc instability model. They find a viscosity parameter ? ? 1. Although this is much less than values (?102) obtained in isothermal slab models it is not consistent with the accretion disc model assumptions.

Idan, I.; Lasota, J. P.; Hameury, J.-M.; Shaviv, G.

1999-04-01

229

Revival of the Jumping Disc  

ERIC Educational Resources Information Center

Snap discs made of bimetal have many technical applications as thermostats. Jumping discs are a toy version of such snap discs. Besides giving technical information, we describe physical investigations. We show especially how, through simple measurements and calculations, you can determine the initial speed ([approximately equal to]3.5 m…

Ucke, C.; Schlichting, H-J.

2009-01-01

230

The Chemistry of Optical Discs.  

ERIC Educational Resources Information Center

|Explains the chemistry used in compact discs (CD), digital versatile discs (DVD), and magneto-optical (MO) discs focusing on the steps of initial creation of the mold, the molding of the polycarbonate, the deposition of the reflective layers, the lacquering of the CDs, and the bonding of DVDs. (Contains 15 references.) (YDS)|

Birkett, David

2002-01-01

231

Mesenteric Defect with Internal Herniation in the Pediatric Emergency Department: An Unusual Presentation of Acute Abdomen.  

PubMed

Internal herniation is a rare cause of intestinal obstruction, especially in the emergency department. We report a child with acute abdomen resulting from transmesenteric internal herniation of the small bowel. Radiographic findings revealed gaseous distension of the bowel loops in the upper abdominal area with a paucity of gas in the lower abdomen. Operative finding showed gangrenous small bowel due to mesenteric defect with an internal herniation. The gangrenous bowel was resected and the patient was discharged with an uneventful outcome. We emphasize that early recognition of internal herniation warrants further evaluation and appropriate management. PMID:23597540

Hu, Mei-Hua; Huang, Go-Shine; Chen, Jeng-Chang; Wu, Chang-Teng

2013-01-20

232

Prevalence of Disc Degeneration in Asymptomatic Korean Subjects. Part 1 : Lumbar Spine  

PubMed Central

Objective Asymptomatic patients show high degeneration prevalence at lumbar disc in previous literatures. Unfortunately, there are few Korean data, so the authors attempted to analyze the prevalence of disc degeneration in highly selective asymptomatic Korean subjects using MRI. Methods We performed 3 T MRI sagittal scans from T12 to S1 on 102 asymptomatic subjects (50 men and 52 women) who visited our hospital between the ages of 14 and 82 years (mean age 46.3 years). All images were read independently by three observers (two neurosurgeons and one neuroradiologist) who were not given any information about the subjects. We classified grading for lumbar disc herniation (HN), annular fissure (AF), and nucleus degeneration (ND), using disc degeneration classification. Results The prevalence of HN, AF, and ND were 81.4%, 76.1%, and 75.8% respectively. Almost all levels showed an age-related proportional tendency with some exceptions. Conclusion In asymptomatic Korean subjects, the abnormal findings showed high prevalence of AF, ND, and extrusion. Especially in young ages, the authors found that bulging, protrusion, and AF showed high prevalence at L4/5 and L5/S1. And ND showed high prevalence at L5/S1. So, all lumbar disc degenerations are not pathologic, especially in children and adolescents.

Lee, Tae Hoon; Lim, Soo Mee

2013-01-01

233

Needle puncture injury of the rat intervertebral disc affects torsional and compressive biomechanics differently  

PubMed Central

Needle puncture is a common method of inducing intervertebral disc (IVD) degeneration in small animal models and may have some similarities to IVD injury conditions such as herniation. Yet, the influence of puncture injuries on IVD biomechanics is not well understood. This study quantified the acute effects of anular injury on the biomechanics of rat caudal IVDs in compression and torsion following puncture with 30, 25 and 21 G needles. In compression, puncture injury reduced elastic stiffness by 20% for all needle sizes, but differences between control and punctured discs did not remain after compressive overload. In contrast, torsional parameters associated with anular fiber tension were affected proportionally with needle size. We conclude that IVD injuries that penetrate through the thickness of the annulus affect IVD biomechanics through different mechanisms for compression and torsion. Anular injuries affect torsional properties in a manner directly related to the amount of fiber disruption and compressive properties in a manner that affects pressurization.

Michalek, Arthur J.; Funabashi, Kristin L.

2010-01-01

234

Biomechanics of Disc Degeneration  

PubMed Central

Disc degeneration and associated disorders are among the most debated topics in the orthopedic literature over the past few decades. These may be attributed to interrelated mechanical, biochemical, and environmental factors. The treatment options vary from conservative approaches to surgery, depending on the severity of degeneration and response to conservative therapies. Spinal fusion is considered to be the “gold standard” in surgical methods till date. However, the association of adjacent level degeneration has led to the evolution of motion preservation technologies like spinal arthroplasty and posterior dynamic stabilization systems. These new technologies are aimed to address pain and preserve motion while maintaining a proper load sharing among various spinal elements. This paper provides an elaborative biomechanical review of the technologies aimed to address the disc degeneration and reiterates the point that biomechanical efficacy followed by long-term clinical success will allow these nonfusion technologies as alternatives to fusion, at least in certain patient population.

Palepu, V.; Kodigudla, M.; Goel, V. K.

2012-01-01

235

Ozone Nucleolysis for Management of Pain and Disability in Prolapsed Lumber Intervertebral Disc  

PubMed Central

Summary The prevalence rate of low back pain in a number of studies ranged from 22% to 65% in one year, and lifetime prevalence ranged from 11% to 84%. Over the years many percutaneous minimally invasive therapeutic modalities have evolved. Intradiscal oxygen-ozone therapy has also showed promising results. We undertook a prospective cohort study to evaluate the therapeutic outcome of oxygen-ozone therapy on patients with lumber disc herniation in the Indian population. After obtaining ethical committee and investigational review board permission, 53 consecutive patients complying with selection criteria were treated with a single session of oxygen-ozone therapy. All presented with clinical signs of lumber nerve root compression supported by CT and MRI findings. All patients received 3-7 ml of ozone-oxygen mixture at an ozone concentration of29-32 mc/ml of oxygen. Therapeutic outcome was assessed after three weeks, three months, six months, one year and two years on a visual analog scale and Oswestry low back pain disability questionnaire. Pain intensity was significantly reduced following treatment (VAS baseline 7.58±0.86, after three weeks 2.75 ±1.42 and after two years 2.64±2.14). Similarly the Oswestry disability index showed a remarkable improvement in the functional status of the patients (p<0.05). No major complication was observed in this case series. Oxygen-ozone treatment is highly effective in relieving low back pain due to lumber disc herniation.

Das, G.; Ray, S.; Ishwarari, S.; Roy, M.; Ghosh, P.

2009-01-01

236

Incarcerated Trocar Site Herniation of the Small Bowel following Laparoscopic Myomectomy  

PubMed Central

Small bowel herniation through the fascial defect created by the entry of trocars is one of the major complications of the laparoscopic surgery. In this paper, we describe a 42-year-old woman developing an incarcerated trocar site herniation of the small bowel following laparoscopic myomectomy and treated by laparoscopic approach.

Zomer, Monica Tessmann; de Azevedo, Rafael Menezes

2013-01-01

237

Incarcerated Trocar Site Herniation of the Small Bowel following Laparoscopic Myomectomy.  

PubMed

Small bowel herniation through the fascial defect created by the entry of trocars is one of the major complications of the laparoscopic surgery. In this paper, we describe a 42-year-old woman developing an incarcerated trocar site herniation of the small bowel following laparoscopic myomectomy and treated by laparoscopic approach. PMID:23956895

Kondo, William; Zomer, Monica Tessmann; Braga-Baiak, Andresa; de Azevedo, Rafael Menezes

2013-07-14

238

Intermittent cervical traction for cervical radiculopathy caused by large-volume herniated disks  

Microsoft Academic Search

Objective: To describe the use of intermittent cervical traction in managing 4 patients with cervical radiculopathy and large-volume herniated disks. Clinical Features: Four patients had neck pain radiating to the arm. The clinical examination was typical in all cases for radiculopathy of cervical origin. Magnetic resonance imaging (MRI) of the cervical spine revealed large-volume herniated disks in all patients. Intervention

Constantine Constantoyannis; Demetres Konstantinou; Harry Kourtopoulos; Nicolas Papadakis

2002-01-01

239

Spontaneous Transient Lateral Thoracic Lung Herniation Resulting in Systemic Inflammatory Response Syndrome (SIRS) and Subsequent Contralateral Lung Injury.  

PubMed

Lung herniation is a relatively rare clinical entity that is most commonly either congenital or acquired traumatically. We describe a case of spontaneous lung herniation secondary to acute cough in an obese male smoker complicated by contralateral acute lung injury and systemic inflammatory response syndrome (SIRS). Mechanisms of lung herniation, classification, diagnosis, and management will be discussed. PMID:22084612

Kaliyadan, Antony; Kebede, Amal; Ali, Tabassum; Karchevsky, Michael; Vasseur, Bernard; Patel, Nirav

2011-07-03

240

Spontaneous Transient Lateral Thoracic Lung Herniation Resulting in Systemic Inflammatory Response Syndrome (SIRS) and Subsequent Contralateral Lung Injury  

PubMed Central

Lung herniation is a relatively rare clinical entity that is most commonly either congenital or acquired traumatically. We describe a case of spontaneous lung herniation secondary to acute cough in an obese male smoker complicated by contralateral acute lung injury and systemic inflammatory response syndrome (SIRS). Mechanisms of lung herniation, classification, diagnosis, and management will be discussed.

Kaliyadan, Antony; Kebede, Amal; Ali, Tabassum; Karchevsky, Michael; Vasseur, Bernard; Patel, Nirav

2011-01-01

241

Cumulative occupational lumbar load and lumbar disc disease - results of a German multi-center case-control study (EPILIFT)  

PubMed Central

Background The to date evidence for a dose-response relationship between physical workload and the development of lumbar disc diseases is limited. We therefore investigated the possible etiologic relevance of cumulative occupational lumbar load to lumbar disc diseases in a multi-center case-control study. Methods In four study regions in Germany (Frankfurt/Main, Freiburg, Halle/Saale, Regensburg), patients seeking medical care for pain associated with clinically and radiologically verified lumbar disc herniation (286 males, 278 females) or symptomatic lumbar disc narrowing (145 males, 206 females) were prospectively recruited. Population control subjects (453 males and 448 females) were drawn from the regional population registers. Cases and control subjects were between 25 and 70 years of age. In a structured personal interview, a complete occupational history was elicited to identify subjects with certain minimum workloads. On the basis of job task-specific supplementary surveys performed by technical experts, the situational lumbar load represented by the compressive force at the lumbosacral disc was determined via biomechanical model calculations for any working situation with object handling and load-intensive postures during the total working life. For this analysis, all manual handling of objects of about 5 kilograms or more and postures with trunk inclination of 20 degrees or more are included in the calculation of cumulative lumbar load. Confounder selection was based on biologic plausibility and on the change-in-estimate criterion. Odds ratios (OR) and 95% confidence intervals (CI) were calculated separately for men and women using unconditional logistic regression analysis, adjusted for age, region, and unemployment as major life event (in males) or psychosocial strain at work (in females), respectively. To further elucidate the contribution of past physical workload to the development of lumbar disc diseases, we performed lag-time analyses. Results We found a positive dose-response relationship between cumulative occupational lumbar load and lumbar disc herniation as well as lumbar disc narrowing among men and women. Even past lumbar load seems to contribute to the risk of lumbar disc disease. Conclusion According to our study, cumulative physical workload is related to lumbar disc diseases among men and women.

Seidler, Andreas; Bergmann, Annekatrin; Jager, Matthias; Ellegast, Rolf; Ditchen, Dirk; Elsner, Gine; Grifka, Joachim; Haerting, Johannes; Hofmann, Friedrich; Linhardt, Oliver; Luttmann, Alwin; Michaelis, Martina; Petereit-Haack, Gabriela; Schumann, Barbara; Bolm-Audorff, Ulrich

2009-01-01

242

Mammoth orbitofrontal neurofibromatosis with herniating meningo-encephalocele.  

PubMed

We are presenting a mammoth orbito-frontal neurofibroma with a herniating meningo-encephalocele in a 23 year old African male. The tumour measured 87cm x 54cm and occupied the right orbito-temporo-facial region and had destroyed the right orbit. A pre operative embolization of the feeding vessels was followed by a one stage near total excision of the tumour and repair of the meningo-encephalocele in hypotensive anaesthesia. The excised tumour weighed 8 Kg and, to the best of our knowledge, is the largest orbito-facial neurofibroma reported in literature. PMID:20924457

Dhanraj, Prema; Paul, Kingsly; Lamba, Shashank; Shetty, Rahul

2010-01-01

243

Pathophysiology of Degenerative Disc Disease  

PubMed Central

The intervertebral disc is characterized by a tension-resisting annulus fibrosus and a compression-resisting nucleus pulposus composed largely of proteoglycan. The most important function of the annulus and nucleus is to provide mechanical stability to the disc. Degenerative disc disease in the lumbar spine is a serious health problem. Although the three joint complex model of the degenerative process is widely accepted, the etiological basis of this degeneration is poorly understood. With the recent progress in molecular biology and modern biological techniques, there has been dramatic improvement in the understanding of aging and degenerative changes of the disc. Knowledge of the pathophysiology of the disc degeneration can help in the appropriate choice of treatment and to develop tissue engineering for biological restoration of degenerated discs.

2009-01-01

244

Revival of the jumping disc  

NASA Astrophysics Data System (ADS)

Snap discs made of bimetal have many technical applications as thermostats. Jumping discs are a toy version of such snap discs. Besides giving technical information, we describe physical investigations. We show especially how, through simple measurements and calculations, you can determine the initial speed (~3.5 m s-1), the acceleration (~30 000 m s-2) and the lower and upper snap temperature (~31; ~99 °C). High speed videos give even deeper insight into the jump.

Ucke, C.; Schlichting, H.-J.

2009-11-01

245

Effect of Interlaminar Epidural Steroid Injection in Acute and Subacute Pain Due to Lumbar Disk Herniation: A Randomized Comparison of 2 Different Protocols  

PubMed Central

In order to assess the efficacy of epidural steroid injections (ESI) in acute and subacute pain due to lumbar spine disk herniation, we conducted a randomized trial, comparing 2 different protocols. Fourty patients with radicular pain due to L4-L5 and L5-S1 disc herniation were assigned to receive either 3 consecutive ESI every 24 hours through a spinal catheter (group A) or 3 consecutive ESI every 10 days with an epidural needle (group B). All patients had improved Oswestry Disabilty Index (ODI) and the Visual Analog Scale (VAS) for pain scores at 1 month of follow-up compared to baseline, while no significant differences were observed between the 2 groups. The scores for group B were statistically significant lower at 2 months of follow-up compared to those of group A. The improvement in the scores of group B was continuous since the mean scores at 2 months of follow up were lower compared to the respective scores at 1 month. Protocol B (3 consecutive ESI every 10 days) was found more effective in the treatment of subacute pain compared to Protocol A (3 consecutive ESI every 24 hours) with statistically significant differences in the ODI and VAS scores at 2 months of follow-up.

Gelalis, I.D; Arnaoutoglou, E; Pakos, E.E; Politis, A.N; Rapti, M; Xenakis, T.A; Papadopoulos, G

2009-01-01

246

Preparation of ormetoprim sulfadimethoxine medicated discs for disc diffusion assay  

Technology Transfer Automated Retrieval System (TEKTRAN)

Romet (a blend of ormetoprim and sulfadimethoxine) is a typeA medicated article for the manufacture of medicated feed in the catfish industry. Recently, the commercial manufacture of ormetoprim–sulfadimethoxine susceptibility discs was discontinued. Ormetoprim–sulfadimethoxine discs were prepared at...

247

Prevalence of Disc Degeneration in Asymptomatic Korean Subjects. Part 2 : Cervical Spine  

PubMed Central

Objective Similar to back pain, neck pain has recently shown to have increasing prevalence. Magnetic resonance imaging (MRI) is useful in identifying the causes of neck pain. However, MRI shows not only pathological lesions but also physiological changes at the same time, and there are few Korean data. The authors have attempted to analyze the prevalence of disc degeneration in highly selective asymptomatic Korean subjects using MRI. Methods We performed 3 T MRI sagittal scans from C2 to T1 on 102 asymptomatic subjects (50 men and 52 women) who visited our hospital between the ages of 14 and 82 years (mean age 46.3 years). All images were read independently by three observers (two neurosurgeons and one neuroradiologist) who were not given any information about the subjects. We classified grading for cervical disc herniation (HN), annular fissure (AF), and nucleus degeneration (ND), using disc degeneration classification. Results The prevalence of HN, AF, and ND were 81.0%, 85.9%, and 95.4%, respectively. High prevalence of HN, AF, and ND was shown compared to previous literature. Conclusion In asymptomatic Korean subjects, the abnormal findings of 3 T MRI showed a high prevalence in HN, AF, and ND. Several factors might play important roles in these results, such as population-specific characters, MRI field strength, and disc degeneration grading system.

Lee, Tae Hoon; Lim, Soo Mee

2013-01-01

248

Origin and structure of the Galactic disc(s)  

NASA Astrophysics Data System (ADS)

We examine the chemical and dynamical structure in the solar neighbourhood of a model Galaxy that is the endpoint of a simulation of the chemical evolution of the Milky Way in the presence of radial mixing of stars and gas. Although the simulation's star formation rate declines monotonically from its unique peak and no merger or tidal event ever takes place, the model replicates all known properties of a thick disc, as well as matching special features of the local stellar population such as a metal-poor extension of the thin disc that has high rotational velocity. We divide the disc by chemistry and relate this dissection to observationally more convenient kinematic selection criteria. We conclude that the observed chemistry of the Galactic disc does not provide convincing evidence for a violent origin of the thick disc, as has been widely claimed.

Schönrich, Ralph; Binney, James

2009-11-01

249

Fantastic Disc Activities for Fitness  

ERIC Educational Resources Information Center

Disc activities are an excellent elementary content area for both skill and fitness enhancement. They may occur through progressive skill and drill practice, small sided-game examples, modifications of traditional disc activities appropriate to large groups, and with adjustments designed to increase activity and fitness levels. For games in this…

Griffin, Michael R.; Johnson, Romona; Thomas, Jessica; Spell, Melissa; Popham, John; Croft, Brent; Umpleby, Albert; Verbel, Eric

2005-01-01

250

Fantastic Disc Activities for Fitness  

ERIC Educational Resources Information Center

|Disc activities are an excellent elementary content area for both skill and fitness enhancement. They may occur through progressive skill and drill practice, small sided-game examples, modifications of traditional disc activities appropriate to large groups, and with adjustments designed to increase activity and fitness levels. For games in this…

Griffin, Michael R.; Johnson, Romona; Thomas, Jessica; Spell, Melissa; Popham, John; Croft, Brent; Umpleby, Albert; Verbel, Eric

2005-01-01

251

Mechanical profiling of intervertebral discs  

PubMed Central

Despite recent advances in imaging diagnostic technology and additional treatment options our ability to prevent or inhibit discogenic back pain has not drastically improved. The challenge of linking early degenerative patterns to dysfunction and pain remains. Using a novel material testing device designated the Tissue Diagnostic Instrument (TDI) we measured the local stiffness and strain energy absorption in the radial direction of 13 intact intervertebral discs; effectively generating a mechanical profile of each disc. Prior to measuring mechanical properties, an MR image was taken of each spine segment and the discs were radiologically scored according to the Pfirrmann scale. After testing, a sagittal portion of each L1-L2 disc was excised from each of four spines for histology. No significant correlations were found between Pfirrmann grade and mechanical data. However, polarized light microscopy images of disc sections indicated correlations between local tissue modulus measured with the TDI and the clarity and density of lamellar striations.

Schultz, David S.; Rodriguez, Azucena G.; Hansma, Paul K.; Lotz, Jeffrey C.

2009-01-01

252

Imaging the intervertebral disk: age-related changes, herniations, and radicular pain.  

PubMed

The articulations of the spinal motion segment, the intervertebral disk, and the zygapophyseal joints, inevitably undergo age-related changes. This article focuses on the intervertebral disk, specifically when fissures sufficiently weaken the posterior annulus so as to allow herniation of nuclear material into the outer annular structure as a contained protrusion or breach the annulus and pass into the epidural space as an extrusion. This article examines the imaging of the age-related changes of the disk and disk herniation: nomenclature, the reliability and relative merits of imaging modalities, the imaging natural history of disk herniations, and, most importantly, the clinical significance. PMID:22643389

Del Grande, Filippo; Maus, Timothy P; Carrino, John A

2012-07-01

253

Surgical vs Nonoperative Treatment for Lumbar Disk Herniation  

PubMed Central

Context For patients with lumbar disk herniation, the Spine Patient Outcomes Research Trial (SPORT) randomized trial intent-to-treat analysis showed small but not statistically significant differences in favor of diskectomy compared with usual care. However, the large numbers of patients who crossed over between assigned groups precluded any conclusions about the comparative effectiveness of operative therapy vs usual care. Objective To compare the treatment effects of diskectomy and usual care. Design, Setting, and Patients Prospective observational cohort of surgical candidates with imaging-confirmed lumbar intervertebral disk herniation who were treated at 13 spine clinics in 11 US states and who met the SPORT eligibility criteria but declined randomization between March 2000 and March 2003. Interventions Standard open diskectomy vs usual nonoperative care. Main Outcome Measures Changes from baseline in the Medical Outcomes Study Short-Form Health Survey (SF-36) bodily pain and physical function scales and the modified Oswestry Disability Index (American Academy of Orthopaedic Surgeons/MODEMS version). Results Of the 743 patients enrolled in the observational cohort, 528 patients received surgery and 191 received usual nonoperative care. At 3 months, patients who chose surgery had greater improvement in the primary outcome measures of bodily pain (mean change: surgery, 40.9 vs nonoperative care, 26.0; treatment effect, 14.8; 95% confidence interval, 10.8-18.9), physical function (mean change: surgery, 40.7 vs nonoperative care, 25.3; treatment effect, 15.4; 95% CI, 11.6-19.2), and Oswestry Disability Index (mean change: surgery, ?36.1 vs nonoperative care, ?20.9; treatment effect, ?15.2; 95% CI, ?18.5. to ?11.8). These differences narrowed somewhat at 2 years: bodily pain (mean change: surgery, 42.6 vs nonoperative care, 32.4; treatment effect, 10.2; 95% CI, 5.9-14.5), physical function (mean change: surgery, 43.9 vs nonoperavtive care 31.9; treatment effect, 12.0; 95% CI; 7.9-16.1), and Oswestry Disability Index (mean change: surgery ?37.6 vs nonoperative care ?24.2; treatment effect, ?13.4; 95% CI, ?17.0 to ?9.7). Conclusions Patients with persistent sciatica from lumbar disk herniation improved in both operated and usual care groups. Those who chose operative intervention reported greater improvements than patients who elected nonoperative care. However, nonrandomized comparisons of self-reported outcomes are subject to potential confounding and must be interpreted cautiously. Trial Registration clinicaltrials.gov Identifier: NCT00000410

Weinstein, James N.; Lurie, Jon D.; Tosteson, Tor D.; Skinner, Jonathan S.; Hanscom, Brett; Tosteson, Anna N. A.; Herkowitz, Harry; Fischgrund, Jeffrey; Cammisa, Frank P.; Albert, Todd; Deyo, Richard A.

2008-01-01

254

The Vacuum Bubble Nucleation  

SciTech Connect

We study the nucleation of a vacuum bubble via the vacuum-to-vacuum tunneling transition in curved spacetime. We consider Coleman-de Luccia's semiclassical approximation at zero temperature in pure Einstein theory of gravity and the theory with nonminimal coupling. We discuss the dynamics of a nucleated vacuum bubble.

Lee, Bum-Hoon [Department of Physics and Center for Quantum Spacetime, Sogang University Seoul 121-742 (Korea, Republic of); Lee, Wonwoo [Center for Quantum Spacetime, Sogang University, Seoul 121-742 (Korea, Republic of)

2009-07-10

255

Traumatic Acute Brain Herniation through the Ear in a Child  

PubMed Central

A seven-year-old girl presented to Sultan Qaboos University Hospital, Oman, with a history of having been hit by a motor vehicle. After this, she had right-sided cerebrospinal fluid otorrhoea, and a week later, brain matter extruded through the right ear. A computed tomography scan of the brain demonstrated a tegmen fracture communicating with the external auditory canal. There was no hearing or facial nerve impairment and an otoscopic examination showed an intact tympanic membrane. She underwent a transcranial repair of the middle cranial fossa base, which revealed a wide dural and bony defect of the tegmen with herniation of the temporal lobe. Repair was made with an intradural patch of artificial dura. The rarity of this type of presentation of temporal bone fracture and its management are discussed.

Kariyattil, Rajeev; Muthukuttiparambil, Unnikrishnan

2012-01-01

256

CT of lumbar spine disk herniation: correlation with surgical findings  

SciTech Connect

Computed tomography (CT) of the lumbar spine was performed with selectively positioned 5-mm-thick axial cross sections to examine each disk level from the top of the neural foramen to the pedicle of the next caudad vertebra. One hundred consecutive patients with 116 surgical disk explorations were reviewed. There was agreement between the CT and surgical findings in 89 patients (104 explorations) in determination of presence or absence of a herniated nucleus pulposus (HNP). Discrepancy occurred in 12 instances (11 patients): two because of incorrect interpretations, five in previously operated patients, three in spondylolisthesis, and two in spinal stenosis. There were 97 true-positives, eight false-negatives, seven true-negatives, and four false-positives. If nine previously operated patients are excluded from the study, then CT was accurate in detection of presence or absence of an HNP in 93% of the disk explorations.

Firooznia, H.; Benjamin, V.; Kricheff, I.I.; Rafii, M.; Golimbu, C.

1984-03-01

257

Double-disc gate valve  

DOEpatents

This invention relates to an improvement in a conventional double-disc gate valve having a vertically movable gate assembly including a wedge, spreaders slidably engaged therewtih, a valve disc carried by the spreaders. When the gate assembly is lowered to a selected point in the valve casing, the valve discs are moved transversely outward to close inlet and outlet ports in the casing. The valve includes hold-down means for guiding the disc-and-spreader assemblies as they are moved transversely outward and inward. If such valves are operated at relatively high differential pressures, they sometimes jam during opening. Such jamming has been a problem for many years in gate valves used in gaseous diffusion plants for the separtion of uranium isotopes. The invention is based on the finding that the above-mentioned jamming results when the outlet disc tilts about its horizontal axis in a certain way during opening of the valve. In accordance with the invention, tilting of the outlet disc is maintained at a tolerable value by providing the disc with a rigid downwardly extending member and by providing the casing with a stop for limiting inward arcuate movement of the member to a preselected value during opening of the valve.

Wheatley, Seth J. (Oak Ridge, TN)

1979-01-01

258

Use of vacuum-assisted closure in open incisional hernia repair: a novel approach to prevent seroma formation  

Microsoft Academic Search

Introduction  Frequent complications in incisional hernia surgery are re-herniation, wound infection and seroma formation. The use of subatmospheric\\u000a pressure dressings such as the vacuum-assisted closure (VAC) device has been shown to be an effective way to accelerate healing\\u000a of various wounds. Here, we describe the application of the VAC device as a postoperative dressing to prevent seroma formation\\u000a after open incisional

M. López-Cano; M. Armengol-Carrasco

259

Surgical vs Nonoperative Treatment for Lumbar Disk Herniation  

PubMed Central

Context Lumbar diskectomy is the most common surgical procedure performed for back and leg symptoms in US patients, but the efficacy of the procedure relative to nonoperative care remains controversial. Objective To assess the efficacy of surgery for lumbar intervertebral disk herniation. Design, Setting, and Patients The Spine Patient Outcomes Research Trial, a randomized clinical trial enrolling patients between March 2000 and November 2004 from 13 multidisciplinary spine clinics in 11 US states. Patients were 501 surgical candidates (mean age, 42 years; 42% women) with imaging-confirmed lumbar intervertebral disk herniation and persistent signs and symptoms of radiculopathy for at least 6 weeks. Interventions Standard open diskectomy vs nonoperative treatment individualized to the patient. Main Outcome Measures Primary outcomes were changes from baseline for the Medical Outcomes Study 36-item Short-Form Health Survey bodily pain and physical function scales and the modified Oswestry Disability Index (American Academy of Orthopaedic Surgeons MODEMS version) at 6 weeks, 3 months, 6 months, and 1 and 2 years from enrollment. Secondary outcomes included sciatica severity as measured by the Sciatica Bothersomeness Index, satisfaction with symptoms, self-reported improvement, and employment status. Results Adherence to assigned treatment was limited: 50% of patients assigned to surgery received surgery within 3 months of enrollment, while 30% of those assigned to nonoperative treatment received surgery in the same period. Intent-to-treat analyses demonstrated substantial improvements for all primary and secondary outcomes in both treatment groups. Between-group differences in improvements were consistently in favor of surgery for all periods but were small and not statistically significant for the primary outcomes. Conclusions Patients in both the surgery and the nonoperative treatment groups improved substantially over a 2-year period. Because of the large numbers of patients who crossed over in both directions, conclusions about the superiority or equivalence of the treatments are not warranted based on the intent-to-treat analysis. Trial Registration clinicaltrials.gov Identifier: NCT00000410

Weinstein, James N.; Tosteson, Tor D.; Lurie, Jon D.; Tosteson, Anna N. A.; Hanscom, Brett; Skinner, Jonathan S.; Abdu, William A.; Hilibrand, Alan S.; Boden, Scott D.; Deyo, Richard A.

2008-01-01

260

Recurrent ventral herniation in Ehlers-Danlos syndrome.  

PubMed

Ehlers-Danlos syndrome is an inherited collagen disorder characterized by skin hyperextensibility, joint laxity, and tissue friability. In this study, it was hypothesized that Ehlers-Danlos syndrome is frequently undiagnosed in patients who present for repair of ventral abdominal wall hernias. A retrospective chart review was conducted, and patients who had presented for elective repair of recurrent abdominal wall herniation were identified. In all patients, one or more prior attempts at repair with either mesh or autologous tissues had failed. Patients in whom abdominal wall components were lost secondary to extirpation or trauma, patients who had required acute closure, and patients with less than 2 months of follow-up were excluded. Twenty patients met these criteria. Twenty cases of recurrent ventral hernia repairs were reviewed, with special attention to identification of the preoperative diagnosis of Ehlers-Danlos syndrome. Patients ranged in age from 29 to 75 years, with a mean age of 54 years. Five patients were male (25 percent), and 15 were female (75 percent). The majority (95 percent) were Caucasian. The most common initial procedures were gynecologic in origin (35 percent). A precise closure technique that minimizes recurrence after ventral hernia repairs was used. With use of this technique, there was only one recurrence over a follow-up period that ranged from 2 to 60 months (mean follow-up duration, 25.7 months). Two patients with Ehlers-Danlos syndrome were identified, and their cases are presented in this article. The "components separation" technique with primary component approximation and mesh overlay was used for defect closure in the two cases presented. The identification of these two patients suggests the possibility of underdiagnosis of Ehlers-Danlos syndrome among patients who undergo repeated ventral hernia repair and who have had previous adverse postoperative outcomes. There are no previous reports in the literature that address recurrent ventral abdominal herniation in patients with Ehlers-Danlos syndrome. PMID:11129180

Girotto, J A; Malaisrie, S C; Bulkely, G; Manson, P N

2000-12-01

261

A quantitative method for comparing the distribution of cerebral trauma in closed-head injuries with and without tentorial herniation.  

PubMed

Damage to the cerebral and cerebellar hemispheres and brain-stem was investigated in forty-seven cases of closed-head injury of which twenty-four had undergone tentorial herniation. The damage was assessed by eye in coronal sections as well as microscopically using celloidin and paraffin techniques. All cases had damage to the hemispheres and brain stem. The types and positions of the damage were plotted on charts and quantified by using a cm2 grid system. The quantity of the haemorrhage and ischaemia in the hemispheres was found by Student's t-test to be statistically greater (P less than 0.001) for cases which had herniated. Haemorrhage and ischaemia were most frequently seen on the ventral aspect of the hemispheres and particularly the frontal lobes. The distribution of the haemorrhage and ischaemia was the same for both the herniated and non-herniated brains. In a subsample of sixteen cases statistically significant differences were found using the X2 test for the positions of brain-stem damage per se in herniated and non-herniated brains. In a second subsample of thirty-two cases a statistical difference in the position of haemorrhage was also found. The greatest damage to the brain-stem was medial and rostral in herniated brains and paralateral and rostral but extending further caudally in non-herniated brains. The variation in quantity of the five types of damage with length of survival was compared for herniated and non-herniated brains. PMID:6866209

Gibson, P H

262

On total disc replacement.  

PubMed

Low back pain consumes a large part of the community's resources dedicated to health care and sick leave. Back disorders also negatively affect the individual leading to pain suffering, decreased quality-of-life and disability. Chronic low back pain (CLBP) due to degenerative disc disease (DDD) is today often treated with fusion when conservative treatment has failed and symptoms are severe. This treatment is as successful as arthroplasty is for hip arthritis in restoring the patient's quality of life and reducing disability. Even so, there are some problems with this treatment, one of these being recurrent CLBP from an adjacent segment (ASD) after primarily successful surgery. This has led to the development of alternative surgical treatments and devices that maintain or restore mobility, in order to reduce the risk for ASD. Of these new devices, the most frequently used are the disc prostheses used in Total Disc Replacement (TDR). This thesis is based on four studies comparing total disc replacement with posterior fusion. The studies are all based on a material of 152 patients with DDD in one or two segments, aged 20-55 years that were randomly treated with either posterior fusion or TDR. The first study concerned clinical outcome and complications. Follow-up was 100% at both one and two years. It revealed that both treatment groups had a clear benefit from treatment and that patients with TDR were better in almost all outcome scores at one-year follow-up. Fusion patients continued to improve during the second year. At two-year follow-up there was a remaining difference in favour of TDR for back pain. 73% in the TDR group and 63% in the fusion group were much better or totally pain-free (n.s.), while twice as many patients in the TDR group were totally pain free (30%) compared to the fusion group (15%). Time of surgery and total time in hospital were shorter in the TDR group. There was no difference in complications and reoperations, except that seventeen of the patients in the fusion group were re-operated for removal of their implants. The second study concerned sex life and sexual function. TDR is performed via an anterior approach, an approach that has been used for a long time for various procedures on the lumbar spine. A frequent complication reported in males when this approach is used is persistent retrograde ejaculation. The TDR group in this material was operated via an extra-peritoneal approach to the retroperitoneal space, and there were no cases of persistent retrograde ejaculation. There was a surprisingly high frequency of men in the fusion group reporting deterioration in ability to have an orgasm postoperatively. Preoperative sex life was severely hampered in the majority of patients in the entire material, but sex life underwent a marked improvement in both treatment groups by the two-year follow-up that correlated with reduction in back pain. The third study was on mobility in the lumbar spinal segments, where X-rays were taken in full extension and flexion prior to surgery and at two-year follow-up. Analysis of the films showed that 78% of the patients in the fusion group reached the surgical goal (non-mobility) and that 89% of the TDR patients maintained mobility. Preoperative disc height was lower than in a normative database in both groups, and remained lower in the fusion group, while it became higher in the TDR group. Mobility in the operated segment increased in the TDR group postoperatively. Mobility at the rest of the lumbar spine increased in both treatment groups. Mobility in adjacent segments was within the norm postoperatively, but slightly larger in the fusion group. In the fourth study the health economics of TDR vs Fusion was analysed. The hospital costs for the procedure were higher for patients in the fusion group compared to the TDR group, and the TDR patients were on sick-leave two months less. In all, these studies showed that the results in the TDR group were as good as in the fusion group. Patients are more likely to be totally pain-free when treated with TDR compared to fusion

Berg, Svante

2011-02-01

263

Post-traumatic diaphragmatic herniation of the liver, examined by positron emission tomography: case report  

PubMed Central

We present a case of post-traumatic diaphragmatic herniation of the liver, which mimicked an intrathoracic tumor. After an automobile accident, the patient underwent thoracotomies for hemothorax and lung cancer in the right chest. Seven months later, computed tomography (CT) demonstrated a round tumor in the thorax adjacent to the right diaphragm with a higher density than the liver parenchyma. An intrathoracic tumor including a primary or metastatic lung cancer was suspected. However, positron emission tomography (PET) showed that the uptake of fluorine-18-fluorodeoxyglucose (FDG) was identical to that in the liver, and the tumor appeared to be contiguous with the liver. Thus, we suspected liver herniation. Core needle biopsy revealed liver cells without neoplastic tissue. Upon surgical exploration, herniation of the liver was found and repaired. PET was helpful in providing morphological and functional information leading to accurate diagnosis of liver herniation in this unusual case.

2011-01-01

264

Correlations between severity of clinical signs and histopathological changes in 60 dogs with spinal cord injury associated with acute thoracolumbar intervertebral disc disease.  

PubMed

The outcome of spinal surgery in dogs with absent voluntary motor function and nociception following intervertebral disc (IVD) herniation is highly variable, which likely attests to differences in the severity of spinal cord damage. This retrospective study evaluated the extent to which neurological signs correlated with histologically detected spinal cord damage in 60 dogs that were euthanased because of thoracolumbar IVD herniation. Clinical neurological grades correlated significantly with the extent of white matter damage (P<0.001). However, loss of nociception also occurred in 6/31 (19%) dogs with relatively mild histological changes. The duration of clinical signs, Schiff-Sherrington posture, loss of reflexes and pain on spinal palpation were not significantly associated with the severity of spinal cord damage. Although clinical-pathological correlation was generally good, some clinical signs frequently thought to indicate severe cord injury did not always correlate with the degree of cord damage, suggesting functional rather than structural impairment in some cases. PMID:23702280

Henke, D; Vandevelde, M; Doherr, M G; Stöckli, M; Forterre, F

2013-05-20

265

Spinal cord herniation: a misdiagnosed and treatable cause of thoracic myelopathy  

Microsoft Academic Search

This study is a case report and review of the literature. Spinal cord herniation is a rare, although increasingly recognized,\\u000a cause of spinal cord dysfunction. It is due to an anterior dural defect, through which the spinal cord herniates. The purpose\\u000a of this article is to report the authors’ experience and to provide insight on clinical presentation and radiological signs

Fahed Zairi; Laurent Thines; Philippe Bourgeois; Olivier Dereeper; Richard Assaker

2010-01-01

266

Incisional bowel herniations after operative laparoscopy: A series of nineteen cases and review of the literature  

Microsoft Academic Search

Objectives: The objectives of this report were (1) to identify all cases of incisional bowel herniations noted after operative laparoscopy in 11 participating institutions and (2) to report the clinical details of such patients.Study Design: A retrospective case review was performed.Results: Nineteen cases of incisional bowel herniation were identified. The average age of the patients was 50.5 years. Initial laparoscopic

Guy M. Boike; Charles E. Miller; Nick M. Spirtos; Jeffrey M. Fowler; Robert Summitt; James W. Orr

1995-01-01

267

Reservoir herniation as a complication of three-piece penile prosthesis insertion  

Microsoft Academic Search

Objectives. To obtain data concerning the incidence and management of reservoir herniation in inflatable penile prosthesis surgery in a clinical investigation. Reservoir herniation after scrotal placement of inflatable penile prosthesis is an unusual complication, and a review of the published medical reports reveals only anecdotal reports and no definitive articles.Methods. A multi-item self-addressed questionnaire was mailed to the members of

Hossein Sadeghi-Nejad; Anoop Sharma; Robert J Irwin; Steven K Wilson; John R Delk

2001-01-01

268

Enlivening Physics, a Local Video Disc Project.  

ERIC Educational Resources Information Center

|Describes how to make and use an inexpensive video disc of physics demonstrations. Discusses the background, production of the disc, subject of the disc including angular momentum, "monkey and the hunter" experiment, Doppler shift, pressure of a constant volume of gas thermometer, and wave effects, and using the disc in classroom. (YP)|

McInerney, M.

1989-01-01

269

The mechanical effects of intervertebral disc lesions  

Microsoft Academic Search

Objective. To determine the mechanical effect of individual concentric tears, radial tears and rim lesions of the intervertebral disc anulus.Design. In vitro dynamic mechanical testing of sheep discs comparing the mechanical behaviour before and after lesion creation.Background. Structural changes to the disc in the form of anular lesions are a feature of disc degeneration and degeneration has been related to

Rosemary E. Thompson; Mark J. Pearcy; Timothy M. Barker

2004-01-01

270

[The attempt to define reciprocal relations between radicular and pseudoradicular syndrome in patients with lumbar disc herniation (1dh)].  

PubMed

Based on history and clinical examination in 100 patients with Idh we selected four clinical features characteristic of radicular and pseudoradicular (spondylogenic) syndrome. The choice was based on data from review of literature. We confirmed that pseudoradicular syndrome features appeared in most of Idh patients. Of the 100 patients in 20% pseudoradicular syndrome features prevailed, 14% experienced mainly radicular syndrome features and 66% patients presented mixed clinical picture. We suggest that above relationships should be considered in clinical practice. PMID:8756250

Styczy?ski, T; Sadowski, A

271

Microsurgical anterior decompression and internal fixation with iliac bone graft and titanium plates for treatment of cervical intervertebral disc herniation.  

PubMed

42 cervical interbody fusions with iliac bone graft and titanium plate fixation were performed between October 1991 and March 1994. The mean follow up period in this study was 10.7 months. In 32 cases fusion was done for 1 and in 10 cases for 2 segments. 2 different types of plates were used. In 25 cases micro-osteosynthesis plates and screws with 2.7 mm diameter were used, and in 17 cases cervical H-plates and screws with 3.5 mm diameter. A favourable outcome was achieved in 31 of 42 cases (74%). Satisfactory pain relief was achieved in 90%. For radicular motor deficit good results were obtained in 84% and for cervical myelopathy in 54%. The 2 different types of plates showed a remarkable difference in the clinical outcome. The results were regarded favourable in 15 of 25 microplate fusions (60%) and in 16 of 17 H-plate fusions (94%). Compression of the bone graft was seen in 5 patients of the micro plate group, however, radiological signs for fusion were present in all 42 cases at follow up. Major surgical complications, damage to neural structures or neurological deterioration did not occur in this study. Plate fixation in cervical interbody fusions seems to be a safe procedure and may reduce graft related complications at the fusion site if the plates and screws are sufficiently well proportioned. A favourable impact upon the results for cervical interbody fusion might be expected and should be further investigated in a long term follow up study. PMID:8748783

Muhlbauer, M; Saringer, W; Aichholzer, M; Sunder-Plassmann, M

1995-01-01

272

Vertical structure of debris discs  

NASA Astrophysics Data System (ADS)

Context: The vertical thickness of debris discs is often used as a measure of these systems' dynamical excitation, and as clues to the presence of hidden massive perturbers such as planetary embryos. However, this argument might be flawed because the observed dust should be naturally placed on inclined orbits by the combined effect of radiation pressure and mutual collisions. Aims: We critically reinvestigate this issue and numerically estimate the “natural” vertical thickness of a collisionally evolving disc, in the absence of any additional perturbing body. Methods: We use a deterministic collisional code, to follow the dynamical evolution of a population of indestructible test grains suffering mutual inelastic impacts. Grain differential sizes as well as the effect of radiation pressure are taken into account. Results: We find that, under the coupled effect of radiation pressure and collisions, grains naturally acquire inclinations of a few degrees. The disc is stratified with respect to grain sizes, the smallest grains having the largest vertical dispersion and the largest being clustered closer to the midplane. Conclusions: Debris discs should have a minimum “natural” observed aspect ratio hmin ~ 0.04±0.02 from visible to mid-IR wavelengths, where the flux is dominated by the smallest bound grains. These values are comparable to the estimated thicknesses of several vertically resolved debris discs, as illustrated by the specific example of AU Mic. For all systems with h ~ hmin, the presence (or absence) of embedded perturbing bodies cannot be inferred from the vertical dispersion of the disc.

Thébault, P.

2009-10-01

273

Vacuum tribological behaviour of self lubricant quasicrystalline composite coatings  

NASA Astrophysics Data System (ADS)

High temperature resistant self-lubricant coatings are needed in space vehicles for components that operate at high temperatures and/or under vacuum. Thick composite lubricant coatings containing quasicrystalline alloys (QC) as the hard phase for wear resistance, have been deposited by thermal spray. The coatings also comprise lubricating materials (silver and BaF2-CaF2 eutectic) and NiCr as the tough component. This paper describes the vacuum tribological properties of TH103, a coating belonging to this family, with excellent microstructural quality. The coating was deposited by HVOF and tested under vacuum on a pin-on-disc tribometer. Different loads, linear speeds and pin materials were studied. The pin scars and disc wear tracks were characterized by EDS-SEM. A minimum mean steady friction coefficient of 0.32 was obtained employing a X-750 Ni superalloy pin in vacuum conditions under 10 N load and 15 cm/s linear speed, showing moderate wear of the disc and low wear of the pin.

Garcí de Blas, F. J.; Román, A.; de Miguel, C.; Longo, F.; Muelas, R.; Agüero, A.

2003-09-01

274

Spinal cord herniation into pseudomeningocele after traumatic nerve root avulsion: case report and review of the literature  

Microsoft Academic Search

We present an extremely rare case of traumatic spinal cord herniation due to a brachial plexus avulsion injury and provide\\u000a a review of the literature of spinal cord herniation. Spinal cord herniation is an uncommon condition that can occur spontaneously\\u000a or as a result of surgery or trauma. This condition often presents with symptoms and signs as Brown-Séquard syndrome. Traumatic

Masato Tanaka; Hisanori Ikuma; Kazuo Nakanishi; Yoshihisa Sugimoto; Haruo Misawa; Tomoaki Takigawa; Toshifumi Ozaki

2008-01-01

275

Percutaneous laser lumbar disc decompression - mechanism of action, indications and contraindications.  

PubMed

This article describes the development of minimally invasive methods in the treatment of lumbar discopathy, with particular attention to percutaneous laser disc decompression (PLDD). The authors discus the therapeutic operating mechanism of PLDD, emphasizing the importance of the thermal characteristics of laser light, which is responsible for the vaporization and ablation of a small amount of tissue from the nucleus pulposus. This causes a significant reduction in pressure in the closed structure of the disc, and consequently reduced compression exerted by the disk on the dural sac and the nerve roots. Improvement in the flow of cerebro-spinal fluid has also been observed on the level at which the operation is performed. On the basis of our own experience and the reports of other authors, we have specified indications and contra-indications for PLDD. Our conclusion is that PLDD is an effective treatment method for low back pain and ischialgia caused by protrusion or herniation of the nucleus pulposus, with elimination or significant reduction in symptoms in over 75% of those treated; reduction or resolution of neurological deficits that arise in the course of lumbar discopathy has also been observed. This method enables one-stage treatment of multi-level degenerative changes in the intervertebral disc. The only absolute contraindications for PLDD are the presence of sequestration, disturbances in blood coagulation, and bacterial infection. PMID:17675991

Maksymowicz, Wojciech; Barczewska, Monika; Sobieraj, Andrzej

2004-06-30

276

Educational Vacuum Trainers  

NSDL National Science Digital Library

Have you inherited a bell jar vacuum system and are scratching your head over how to set it up or are unsure of its operations or capabilities? Or do you want to do more with your bell jar vacuum? The forum on Bell Jar Vacuums - with the topic Vacuum Trainers can help you. The intent of this forum is for this to be a place where technical issues, classroom exercises, activities, etc. can be discussed. There's no endorsement by manufacturers and commercial issues are off limits. Steve Hansen (bell jar expert) gives some brief descriptions of the vacuum trainers that are or have been available over the past decade or so - Varian, MKS, Science Source, American Vacuum Society. Links are provided to various data sheets, articles and online exercises. Steve, the forum moderator has experience in all of these.Keywords: vacuum, "vacuum trainer","bell jar" and/or belljar, MKSVarian, VPAL, VTS, sputtering, plasma

Hansen, Steve

2012-07-31

277

Optimizing process vacuum condensers  

SciTech Connect

Vacuum condensers play a critical role in supporting vacuum processing operations. Although they may appear similar to atmospheric units, vacuum condensers have their own special designs, considerations and installation needs. By adding vacuum condensers, precondensers and intercondensers, system cost efficiency can be optimized. Vacuum-condensing systems permit reclamation of high-value product by use of a precondenser, or reduce operating costs with intercondensers. A precondenser placed between the vacuum vessel and ejector system will recover valuable process vapors and reduce vapor load to an ejector system--minimizing the system`s capital and operating costs. Similarly, an intercondenser positioned between ejector stages can condense motive steam and process vapors and reduce vapor load to downstream ejectors as well as lower capital and operating costs. The paper describes vacuum condenser systems, types of vacuum condensers, shellside condensing, tubeside condensing, noncondensable gases, precondenser pressure drop, system interdependency, equipment installation, and equipment layout.

Lines, J.R.; Tice, D.W. [Graham Mfg. Co., Batavia, NY (United States)

1997-09-01

278

The Classical Vacuum.  

ERIC Educational Resources Information Center

|The classical vacuum of physics is not empty, but contains a distinctive pattern of electromagnetic fields. Discovery of the vacuum, thermal spectrum, classical electron theory, zero-point spectrum, and effects of acceleration are discussed. Connection between thermal radiation and the classical vacuum reveals unexpected unity in the laws of…

Boyer, Timothy H.

1985-01-01

279

Vacuum String Field Theory  

Microsoft Academic Search

This is a brief review of vacuum string field theory, a new approach to open string field theory based on the stable vacuum of the tachyon. We discuss the sliver state explaining its role as a projector in the space of half-string functionals. We review the construction of D-brane solutions in vacuum string field theory, both in the algebraic approach

Leonardo Rastelli; Ashoke Sen; Barton Zwiebach

2001-01-01

280

The Classical Vacuum.  

ERIC Educational Resources Information Center

The classical vacuum of physics is not empty, but contains a distinctive pattern of electromagnetic fields. Discovery of the vacuum, thermal spectrum, classical electron theory, zero-point spectrum, and effects of acceleration are discussed. Connection between thermal radiation and the classical vacuum reveals unexpected unity in the laws of…

Boyer, Timothy H.

1985-01-01

281

Is the Transport of a Gadolinium-Based Contrast Agent Decreased in a Degenerated or Aged Disc? A Post Contrast MRI Study  

PubMed Central

A post contrast magnetic resonance imaging study has been performed in a wide population of low back pain patients to investigate which radiological and phenotypic characteristics influence the penetration of the contrast agent in lumbar discs in vivo. 37 patients affected by different pathologies (disc herniation, spondylolisthesis, foraminal stenosis, central canal stenosis) were enrolled in the study. The selected population included 26 male and 11 female subjects, with a mean age of 42.4±9.3 years (range 18–60). Magnetic resonance images of the lumbar spine were obtained with a 1.5 T scanner (Avanto, Siemens, Erlangen, Germany) with a phased-array back coil. A paramagnetic non–ionic contrast agent was injected with a dose of 0.4 ml/kg. T1-weighted magnetic resonance images were subsequently acquired at 5 time points, 5 and 10 minutes, 2, 4 and 6 hours after injection. Endplates presented clear enhancement already 5 minutes after injection, and showed an increase in the next 2 hours followed by a decrease. At 5 and 10 minutes, virtually no contrast medium was present inside the intervertebral disc; afterwards, enhancement significantly increased. Highly degenerated discs showed higher enhancement in comparison with low and medium degenerated discs. Discs classified as Pfirrmann 5 showed a statistically significant higher enhancement than Pfirrmann 1, 2 and 3 at all time points but the first one, possibly due to vascularization. Disc height collapse and Modic changes significantly increased enhancement. Presence of endplate defects did not show any significant influence on post contrast enhancement, but the lack of a clear classification of endplate defects as seen on magnetic resonance scans may be shadowing some effects. In conclusion, disc height, high level of degeneration and presence of Modic changes are factors which increase post contrast enhancement in the intervertebral disc. The effect of age could not be demonstrated.

Tibiletti, Marta; Galbusera, Fabio; Ciavarro, Cristina; Brayda-Bruno, Marco

2013-01-01

282

Is the transport of a gadolinium-based contrast agent decreased in a degenerated or aged disc? A post contrast MRI study.  

PubMed

A post contrast magnetic resonance imaging study has been performed in a wide population of low back pain patients to investigate which radiological and phenotypic characteristics influence the penetration of the contrast agent in lumbar discs in vivo. 37 patients affected by different pathologies (disc herniation, spondylolisthesis, foraminal stenosis, central canal stenosis) were enrolled in the study. The selected population included 26 male and 11 female subjects, with a mean age of 42.4±9.3 years (range 18-60). Magnetic resonance images of the lumbar spine were obtained with a 1.5 T scanner (Avanto, Siemens, Erlangen, Germany) with a phased-array back coil. A paramagnetic non-ionic contrast agent was injected with a dose of 0.4 ml/kg. T1-weighted magnetic resonance images were subsequently acquired at 5 time points, 5 and 10 minutes, 2, 4 and 6 hours after injection. Endplates presented clear enhancement already 5 minutes after injection, and showed an increase in the next 2 hours followed by a decrease. At 5 and 10 minutes, virtually no contrast medium was present inside the intervertebral disc; afterwards, enhancement significantly increased. Highly degenerated discs showed higher enhancement in comparison with low and medium degenerated discs. Discs classified as Pfirrmann 5 showed a statistically significant higher enhancement than Pfirrmann 1, 2 and 3 at all time points but the first one, possibly due to vascularization. Disc height collapse and Modic changes significantly increased enhancement. Presence of endplate defects did not show any significant influence on post contrast enhancement, but the lack of a clear classification of endplate defects as seen on magnetic resonance scans may be shadowing some effects. In conclusion, disc height, high level of degeneration and presence of Modic changes are factors which increase post contrast enhancement in the intervertebral disc. The effect of age could not be demonstrated. PMID:24146913

Tibiletti, Marta; Galbusera, Fabio; Ciavarro, Cristina; Brayda-Bruno, Marco

2013-10-11

283

Region specific response of intervertebral disc cells to complex dynamic loading: an organ culture study using a dynamic torsion-compression bioreactor.  

PubMed

The spine is routinely subjected to repetitive complex loading consisting of axial compression, torsion, flexion and extension. Mechanical loading is one of the important causes of spinal diseases, including disc herniation and disc degeneration. It is known that static and dynamic compression can lead to progressive disc degeneration, but little is known about the mechanobiology of the disc subjected to combined dynamic compression and torsion. Therefore, the purpose of this study was to compare the mechanobiology of the intervertebral disc when subjected to combined dynamic compression and axial torsion or pure dynamic compression or axial torsion using organ culture. We applied four different loading modalities [1. control: no loading (NL), 2. cyclic compression (CC), 3. cyclic torsion (CT), and 4. combined cyclic compression and torsion (CCT)] on bovine caudal disc explants using our custom made dynamic loading bioreactor for disc organ culture. Loads were applied for 8 h/day and continued for 14 days, all at a physiological magnitude and frequency. Our results provided strong evidence that complex loading induced a stronger degree of disc degeneration compared to one degree of freedom loading. In the CCT group, less than 10% nucleus pulposus (NP) cells survived the 14 days of loading, while cell viabilities were maintained above 70% in the NP of all the other three groups and in the annulus fibrosus (AF) of all the groups. Gene expression analysis revealed a strong up-regulation in matrix genes and matrix remodeling genes in the AF of the CCT group. Cell apoptotic activity and glycosaminoglycan content were also quantified but there were no statistically significant differences found. Cell morphology in the NP of the CCT was changed, as shown by histological evaluation. Our results stress the importance of complex loading on the initiation and progression of disc degeneration. PMID:24013824

Chan, Samantha C W; Walser, Jochen; Käppeli, Patrick; Shamsollahi, Mohammad Javad; Ferguson, Stephen J; Gantenbein-Ritter, Benjamin

2013-08-28

284

Stellar encounters: a stimulus for disc fragmentation?  

NASA Astrophysics Data System (ADS)

An interaction between a star-disc system and another star will perturb the disc, possibly resulting in a significant modification of the disc structure and its properties. It is still unclear if such an encounter can trigger fragmentation of the disc to form brown dwarfs or gas giant planets. This paper details high-resolution smoothed particle hydrodynamics (SPH) simulations investigating the influence of stellar encounters on disc dynamics. Star-star encounters (where the primary has a self-gravitating, marginally stable protostellar disc, and the secondary has no disc) were simulated with various orbital parameters to investigate the resulting disc structure and dynamics. This work is the first of its kind to incorporate realistic radiative transfer techniques to realistically model the resulting thermodynamics. The results suggest that the effect of stellar encounters is to prohibit fragmentation - compressive and shock heating stabilizes the disc, and the radiative cooling is insufficient to trigger gravitational instability. The encounter strips the outer regions of the disc (either through tidal tails or by capture of matter to form a disc around the secondary), which triggers a readjustment of the primary disc to a steeper surface density profile (and a flatter Toomre Q profile). The disc around the secondary plays a role in the potential capture of the secondary to form a binary. However, this applies only to orbits that are parabolic - hyperbolic encounters do not form a secondary disc, and are not captured.

Forgan, Duncan; Rice, Ken

2009-12-01

285

Hydrogel discs for digital microfluidics  

PubMed Central

Hydrogels are networks of hydrophilic polymer chains that are swollen with water, and they are useful for a wide range of applications because they provide stable niches for immobilizing proteins and cells. We report here the marriage of hydrogels with digital microfluidic devices. Until recently, digital microfluidics, a fluid handling technique in which discrete droplets are manipulated electromechanically on the surface of an array of electrodes, has been used only for homogeneous systems involving liquid reagents. Here, we demonstrate for the first time that the cylindrical hydrogel discs can be incorporated into digital microfluidic systems and that these discs can be systematically addressed by droplets of reagents. Droplet movement is observed to be unimpeded by interaction with the gel discs, and gel discs remain stationary when droplets pass through them. Analyte transport into gel discs is observed to be identical to diffusion in cases in which droplets are incubated with gels passively, but transport is enhanced when droplets are continually actuated through the gels. The system is useful for generating integrated enzymatic microreactors and for three-dimensional cell culture. This paper demonstrates a new combination of techniques for lab-on-a-chip systems which we propose will be useful for a wide range of applications.

Fiddes, Lindsey K.; Luk, Vivienne N.; Au, Sam H.; Ng, Alphonsus H. C.; Luk, Victoria; Kumacheva, Eugenia; Wheeler, Aaron R.

2012-01-01

286

Germanium detector vacuum encapsulation  

SciTech Connect

The encapulation of germanium detectors has been a long sought after goal. We have begun to develop encapsulation technology that should significantly improve the viability of germanium gamma-ray detectors for a number of important applications. A specialized vacuum chamber has been constructed in which the detector and the encapsulating module are processed in high vacuum. Very high vacuum conductance is achieved within the valveless encapsulating module. The detector module is then sealed without breaking the chamber vacuum. The details of the vacuum chamber, valveless module, processing, and sealing method are presented in the paper.

Madden, N.W.; Malone, D.F.; Phel, R.H.; Cork, C.P.; Luke, P.N.; Landis, D.A.; Pollard, M.J. (Lawrence Berkeley Laboratory, University of California, Berkeley, CA 94720 (United States))

1991-08-01

287

The dispersal of protoplanetary discs  

NASA Astrophysics Data System (ADS)

Protoplanetary discs are a natural consequence of the star formation process and as such are ubiquitous around low-mass stars. They are fundamental to planet formation as they hold the reservoir of material from which planets form. Their evolution and final dispersal and the timescales that regulate these process are therefore of particular interest. In this contribution I will review the observational evidence for the dispersal of discs being dominated by two timescales and for the final dispersal to occur quickly and from the inside out. I will discuss the current theoretical models, including X-ray photoevaporation, showing that the latter provides a natural explanation to the observed behaviour and review supporting and contrasting evidence. I will finally introduce a new mechanism based on the interaction between planet formation and photoevaporation that may explain a particular class of transition discs with large inner holes and high accretion rates that are problematic for photoevaporation models and planet formation models alone.

Ercolano, Barbara

2013-04-01

288

Artificial Discs for Lumbar and Cervical Degenerative Disc Disease -Update  

PubMed Central

Executive Summary Objective To assess the safety and efficacy of artificial disc replacement (ADR) technology for degenerative disc disease (DDD). Clinical Need Degenerative disc disease is the term used to describe the deterioration of 1 or more intervertebral discs of the spine. The prevalence of DDD is roughly described in proportion to age such that 40% of people aged 40 years have DDD, increasing to 80% among those aged 80 years or older. Low back pain is a common symptom of lumbar DDD; neck and arm pain are common symptoms of cervical DDD. Nonsurgical treatments can be used to relieve pain and minimize disability associated with DDD. However, it is estimated that about 10% to 20% of people with lumbar DDD and up to 30% with cervical DDD will be unresponsive to nonsurgical treatments. In these cases, surgical treatment is considered. Spinal fusion (arthrodesis) is the process of fusing or joining 2 bones and is considered the surgical gold standard for DDD. Artificial disc replacement is the replacement of the degenerated intervertebral disc with an artificial disc in people with DDD of the lumbar or cervical spine that has been unresponsive to nonsurgical treatments for at least 6 months. Unlike spinal fusion, ADR preserves movement of the spine, which is thought to reduce or prevent the development of adjacent segment degeneration. Additionally, a bone graft is not required for ADR, and this alleviates complications, including bone graft donor site pain and pseudoarthrosis. It is estimated that about 5% of patients who require surgery for DDD will be candidates for ADR. Review Strategy The Medical Advisory Secretariat conducted a computerized search of the literature published between 2003 and September 2005 to answer the following questions: What is the effectiveness of ADR in people with DDD of the lumbar or cervical regions of the spine compared with spinal fusion surgery? Does an artificial disc reduce the incidence of adjacent segment degeneration (ASD) compared with spinal fusion? What is the rate of major complications (device failure, reoperation) with artificial discs compared with surgical spinal fusion? One reviewer evaluated the internal validity of the primary studies using the criteria outlined in the Cochrane Musculoskeletal Injuries Group Quality Assessment Tool. The quality of concealment allocation was rated as: A, clearly yes; B, unclear; or C, clearly no. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) system was used to evaluate the overall quality of the body of evidence (defined as 1 or more studies) supporting the research questions explored in this systematic review. A random effects model meta-analysis was conducted when data were available from 2 or more randomized controlled trials (RCTs) and when there was no statistical and or clinical heterogeneity among studies. Bayesian analyses were undertaken to do the following: Examine the influence of missing data on clinical success rates; Compute the probability that artificial discs were superior to spinal fusion (on the basis of clinical success rates); Examine whether the results were sensitive to the choice of noninferiority margin. Summary of Findings The literature search yielded 140 citations. Of these, 1 Cochrane systematic review, 1 RCT, and 10 case series were included in this review. Unpublished data from an RCT reported in the grey literature were obtained from the manufacturer of the device. The search also yielded 8 health technology assessments evaluating ADR that are also included in this review. Six of the 8 health technology assessments concluded that there is insufficient evidence to support the use of either lumbar or cervical ADR. The results of the remaining 2 assessments (one each for lumbar and cervical ADR) led to a National Institute for Clinical Excellence guidance document supporting the safety and effectiveness of lumbar and cervical ADR with the proviso that an ongoing audit of all clinical outcomes be undertaken owing to a lack of long-term outcome data from clinical trials. Regard

2006-01-01

289

Membrane tissue on the optic disc may cause macular schisis associated with a glaucomatous optic disc without optic disc pits.  

PubMed

This article reports a case of possible involvement of membrane tissue on the optic disc with macular schisis formation associated with glaucomatous optic disc without optic disc pits. A 78-year-old man presented with loss of central visual acuity of the left eye. He had a medical history of primary open-angle glaucoma. Visual acuity was 0.6 in his left eye, and funduscopy revealed macular schisis and a glaucomatous optic disc without optic disc pits. Optical coherence tomography (OCT) revealed membrane tissue on the optic disc and a tunnel-like hyporeflective lesion connecting the schisis cavity and a site near the tissue, but no obvious optic disc pit. He underwent pars plana vitrectomy during which the membrane tissue on the disc and internal limiting membrane were removed. Posterior vitreous detachment was observed intraoperatively. Thereafter, the tunnel-like lesion observed on OCT was rapidly obscured and the macular schisis gradually reduced. Eighteen months after surgery, his visual acuity had improved to 0.9 with almost complete regression of the macular schisis. No optic disc pit was visualized after surgery. The changes in OCT findings described here suggest an etiology for macular schisis without optic disc pits in an eye with a glaucomatous optic disc with posterior vitreous detachment. A connection between the schisis cavity and the vitreous cavity may have appeared via the tunnel-like structure due to the membrane tissue exerting traction on the optic disc. PMID:23690678

Takashina, Saori; Saito, Wataru; Noda, Kousuke; Katai, Maki; Ishida, Susumu

2013-05-13

290

Automated volumetric evaluation of stereoscopic disc photography  

PubMed Central

PURPOSE: To develop a fully automated algorithm (AP) to perform a volumetric measure of the optic disc using conventional stereoscopic optic nerve head (ONH) photographs, and to compare algorithm-produced parameters with manual photogrammetry (MP), scanning laser ophthalmoscope (SLO) and optical coherence tomography (OCT) measurements. METHODS: One hundred twenty-two stereoscopic optic disc photographs (61 subjects) were analyzed. Disc area, rim area, cup area, cup/disc area ratio, vertical cup/disc ratio, rim volume and cup volume were automatically computed by the algorithm. Latent variable measurement error models were used to assess measurement reproducibility for the four techniques. RESULTS: AP had better reproducibility for disc area and cup volume and worse reproducibility for cup/disc area ratio and vertical cup/disc ratio, when the measurements were compared to the MP, SLO and OCT methods. CONCLUSION: AP provides a useful technique for an objective quantitative assessment of 3D ONH structures.

Xu, Juan; Ishikawa, Hiroshi; Wollstein, Gadi; Bilonick, Richard A; Kagemann, Larry; Craig, Jamie E; Mackey, David A; Hewitt, Alex W; Schuman, Joel S

2010-01-01

291

The natural history of sciatica associated with disc pathology. A prospective study with clinical and independent radiologic follow-up.  

PubMed

The purpose of this study was to assess the natural history of sciatica due to lumbosacral nerve root compromise and to evaluate the pathomorphologic changes that accompany the natural resolution of the disease. One hundred sixty-five consecutive patients, 114 males and 51 females, with an average age of 41 years (range, 17-72) and an average duration of symptoms of 4.2 months (range, 1-72) presenting with sciatica thought to be due to lumbosacral nerve root compromise were admitted to the study. The cornerstone of treatment was the serial epidural administration of steroid and local anesthetic by the caudal route on an outpatient basis. Lumbar epidural injection or periradicular infiltration at the appropriate level, confirmed under image intensifier, was the next step before considering surgical decompression. An average of three injections (range, 0-8) was received by each patient. Patients underwent clinical examination and computed tomography. Twenty-three patients (14%) underwent surgical decompression. The remainder were clinically assessed at 1 year after presentation, and 111 were rescanned at the appropriate levels. All conservatively managed patients made a satisfactory clinical recovery: average reduction of pain on the visual analog scale was 94% (range, 45-100), and 64 (76%) of the 84 disc herniations and 7 (26%) of the 27 disc bulges showed partial or complete resolution (chi-square = 20.27, P = 0.0001). Thus a high proportion of patients with discogenic sciatica make a satisfactory recovery with aggressive conservative management, and this recovery is accompanied by resolution of disc herniations in a significant number. Only a small proportion of patients needed surgical decompression. PMID:1440010

Bush, K; Cowan, N; Katz, D E; Gishen, P

1992-10-01

292

Gangrenous small bowel obstruction secondary to congenital internal herniation: a case report.  

PubMed

Congenital internal herniation is a rare condition presenting as recurrent abdominal pain or acute intestinal obstruction. In cases in which bowel incarceration or strangulation develop, rapid progression to bowel ischemia, necrosis or perforation is inevitable. Mortality in such cases has been reported to be as high as 50%. Despite advances in imaging modalities, arriving at a pre-operative diagnosis of a congenital internal herniation remains a challenge. We report such a case where imaging was unsuccessful in determining the cause of intestinal obstruction in a 3 year old child. Congenital internal herniation may result in disastrous consequences if not addressed in a timely fashion due to its rarity. Hence a high index of clinical suspicion is needed to avoid missing this diagnosis in a child presenting with recurrent abdominal pain or acute intestinal obstruction. PMID:22582563

Tan, Y L; Alhagi, Muthu V

2012-02-01

293

Two-level total lumbar disc replacement  

Microsoft Academic Search

Total lumbar disc replacement (TDR) has been widely used as a treatment option for 2-level symptomatic degenerative disc disease.\\u000a However, recent studies have presented conflicting results and some authors concluded that outcome deteriorated when disc\\u000a replacement was performed bisegmentally, with an increase of complications for bisegmental replacements in comparison with\\u000a monosegmental disc arthroplasty. The goal of the present retrospective study

Mario Di Silvestre; Georgios Bakaloudis; Francesco Lolli; Francesco Vommaro; Patrizio Parisini

2009-01-01

294

Disc haemorrhages, precursors of open angle glaucoma  

Microsoft Academic Search

In a long-term study of 1270 patients with at least one of the findings, open-angle glaucoma, disc haemorrhages or retinal vein occlusions, disc haemorrhages were witnessed in approximately 20% of the cases with open-angle glaucoma, and were a precursor of glaucomatous disc changes and associated visual field defects. Disc haemorrhages also preceded a rising intraocular pressure (IOP) in the destructive

Bo Sonnsjö; Yvonne Dokmo; Torsten Krakau

2002-01-01

295

Large Residual Strains are Present in the Intervertebral Disc Annulus Fibrosus in the Unloaded State  

PubMed Central

The intervertebral disc annulus fibrosus (AF) is subjected to high circumferential tensile stresses resulting from nucleus pulposus pressurization under axial compression. In other pressure containing tissues, such as blood vessel walls, residual compressive stresses along the inside surface of the tissues without pressurization reduce peak tensile stresses under pressurization. This study hypothesized that similar patterns of residual stress exist in the annulus fibrosus. Accurate characterization of residual stresses is essential for both the incorporation of nonlinear material descriptions into models of the disc as well as the design of effective annulus repair strategies. By imaging nine bovine caudal discs before and after the release of residual stresses via incision, we measured a mean residual stretch of 0.86±0.13 at the inner AF and 1.02±0.08 at the outer AF. These stretch values were used to calculate a gradient of residual stress ranging from ?230±22 kPa of compression at the inner AF to 54±0.2 kPa of tension at the outer AF. Material models of AF have assumed that the AF was in a stress free reference state when there are no external loads. However, this study documents that there are large residual stresses in the AF even without external loads. The release of residual tension in the outer AF by herniation, needle injection or incisions makes closure difficult and may accelerate degeneration of the surrounding tissue. Retention of these residual stresses may be essential to maintaining disc mechanical function and to producing viable AF repair techniques.

Michalek, AJ; Gardner-Morse, MG; Iatridis, JC

2012-01-01

296

Vacuum pump aids ejectors  

SciTech Connect

The steam ejector/vacuum pump hybrid system has been operating satisfactorily since the summer of 1981. This system has essentially been as troublefree as the all-ejector system and, of course, has provided a substantial cost savings. Construction is currently under way to convert the vacuum system of another crude still which is equipped with steam ejectors and barometric condensers to the hybrid system of steam ejectors, surface condensers, and vacuum pumps. This current project is even more financially attractive because it allows a dirty water cooling tower which serves the barometric condensers to be shut down. Providing a vacuum for crude distillation vacuum towers with this hybrid system is by no means the only application of this technique. Any vacuum system consisting of all steam ejectors would be a candidate for this hybrid system and the resulting savings in energy.

Nelson, R.E.

1982-12-01

297

Electromagnetic Levitation of a Disc  

ERIC Educational Resources Information Center

This paper presents a teaching experiment that explores the levitation of a disc of ferromagnetic material in the presence of the magnetic field produced by a single electromagnet. In comparison to the classical experiment of the levitation of a sphere, the main advantage of the proposed laboratory bench is that the uniform magnetic field…

Valle, R.; Neves, F.; de Andrade, R., Jr.; Stephan, R. M.

2012-01-01

298

Stellar discs in massive galaxies  

NASA Astrophysics Data System (ADS)

Excluding those unsettled systems undergoing mergers, bright galaxies come in two flavours: with and without discs. In this work we look for photometric evidence for presence of discs and compare it with kinematic results of the ATLAS3D survey (Cappellari et al. 2011). We fit a Sérsic (1968) function to azimuthally averaged light profiles of ATLAS3D galaxies to derive single component fits and, subsequently, we fit a combination of the Sérsic function (free index n) and an exponential function (n=1) with the purpose of decomposing the light profiles into ``bulge'' and ``disc'' components (B+D model) of all non-barred sample galaxies. We compare the residuals of the B+D models with those of the single Sérsic fits and select the B+D model as preferred only when the improvement is substantial and there are no correlations within residuals. We find that the high angular momentum objects (fast rotators) are disc dominated systems with bulges of typically low n (when their light profiles can be decomposed) or are best represented with a single Sérsic function with a low Sérsic index (n<3). Single component systems with large Sérsic indices are characteristic of low angular momentum objects (slow rotators).

Krajnovi?, D.; Alatalo, K.; Blitz, L.; Bois, M.; Bournaud, F.; Bureau, M.; Cappellari, M.; Davies, R. L.; Davis, T. A.; de Zeeuw, P. T.; Emsellem, E.; Khochfar, S.; Kuntschner, H.; McDermid, R. M.; Morganti, R.; Naab, T.; Sarzi, M.; Scott, N.; Serra, P.; Weijmans, A.; Young, L. M.

2013-07-01

299

Optical Disc Applications in Libraries.  

ERIC Educational Resources Information Center

|Discusses a variety of library applications of optical disc storage technology, including CD-ROM, digital videodisc, and WORM. Research and development projects at the Library of Congress, National Library of Medicine, and National Agricultural Library are described, products offered by library networks are reviewed, and activities in academic…

Andre, Pamela Q. J.

1989-01-01

300

Electromagnetic Levitation of a Disc  

ERIC Educational Resources Information Center

|This paper presents a teaching experiment that explores the levitation of a disc of ferromagnetic material in the presence of the magnetic field produced by a single electromagnet. In comparison to the classical experiment of the levitation of a sphere, the main advantage of the proposed laboratory bench is that the uniform magnetic field…

Valle, R.; Neves, F.; de Andrade, R., Jr.; Stephan, R. M.

2012-01-01

301

512 GB recording on 16-layer optical disc with Blu-ray Disc based optics  

NASA Astrophysics Data System (ADS)

We confirmed the feasibility of a 16-layer write once disc based on Blu-ray Disc optics that was fabricated with inorganic recording material Bi-Ge-O. The total capacity of the disc achieved 400 GB and 512 GB per single disc side with BD 1x recording speed utilizing conventional BD technique.

Inoue, Motohiro; Kosuda, Atsuko; Mishima, Koji; Ushida, Tomoki; Kikukawa, Takashi

2010-06-01

302

?-vacuum and inflationary bispectrum  

Microsoft Academic Search

In this paper, we discuss the non-Gaussianity originated from the ?-vacuum on the CMB anisotropy. For ?-vacuum, there exist correlation between points in the acausal two patches of de Sitter spactime. Such kind of correlation can lead to large local form non-Gaussianity in ?-vacuum. For the single field slow- roll inflationary scenario, the spacetime is in a quasi-de Sitter phase

Wei Xue

2009-01-01

303

Stable counteralignment of a circumbinary disc  

NASA Astrophysics Data System (ADS)

In general, when gas accretes on to a supermassive black hole (SMBH) binary, it is likely to have no prior knowledge of the binary angular momentum. Therefore, a circumbinary disc forms with a random inclination angle ? to the binary. It is known that for ? < 90° the disc will coalign with respect to the binary. If ? > 90°, the disc wholly counteraligns if it satisfies cos ? < -Jd/2Jb, where Jd and Jb are the magnitudes of the disc and binary angular momentum vectors, respectively. If, however, ? > 90° and this criterion is not satisfied, the same disc may counteralign its inner regions and, on longer time-scales, coalign its outer regions. I show that for typical disc parameters, describing an accretion event on to an SMBH binary, a misaligned circumbinary disc is likely to wholly coalign or counteralign with the binary plane. This is because the binary angular momentum dominates the disc angular momentum. However, with extreme parameters (binary mass ratio M2/M1? 1 or binary eccentricity e˜ 1), the same disc may simultaneously coalign and counteralign. It is known that coplanar prograde circumbinary discs are stable. I show that coplanar retrograde circumbinary discs are also stable. A chaotic accretion event on to an SMBH binary will therefore result in a coplanar circumbinary disc that is either prograde or retrograde with respect to the binary plane.

Nixon, Christopher J.

2012-07-01

304

Modelling the Milky Way disc  

NASA Astrophysics Data System (ADS)

RAVE, SEGUE and Hipparcos data are used to study the dynamics of stars in the extended solar neighbourhood. The asymmetric drift of thin disc dwarfs is studied as a function of colour and metallicity. Linear extrapolation of the data falls within the error bars from Aumer & Binney (2009) for local standard of rest. The observed metallicity dependence of the asymmetric drift is consistent with the known radial metallicity distribution in the disc. Implying the asymmetric drift correction to the SEGUE data allows us to reconstruct the behaviour of the rotation curve of the Milky Way in the extended solar neighbourhood. The rotation curve appears to be essentially flat, giving no hint for a dip just outside the solar radius followed by an increase observed in some other data sets. The data are supplemented by tangent point measurements for the inner rotation curve. Thus a synthetic rotation curve of the Milky Way is obtained. It is fitted by a density model consisting of a D! ehnen bulge, an exponential disc with a hole, and a flattened dark matter halo with either cored isothermal or NFW density profile. In this fitting the parameters are constrained to reproduce the local surface density of the disc and the local volume density of the halo, which are known from local stellar dynamics in the solar neighbourhood. Thus the density model of the Milky Way is reconstructed. The vertical structure of the disc of theMilkyWay is consistent with the model by Just & Jahreiß (2010). Some basic features of distribution functions of the Milky Way and of the dynamical heating are also discussed.

Golubov, Oleksiy

2012-10-01

305

Continuous venovenous hemofiltration rapidly lowers toxic metabolites in a patient with MSUD and imminent cerebral herniation.  

PubMed

Maple syrup urine disease (MSUD) is an inborn error of amino acid metabolism. During catabolic stress encephalopathy and brain swelling that can culminate in brain herniation may occur. Beyond the neonatal period, these metabolic decompensations normally can be treated with a conservative dietary emergency regimen. Nevertheless in exceptionally severe cases also older patients may require extracorporeal interventions. We present the case of a 12-year-old patient with cerebral edema and imminent cerebral herniation. Continuous venovenous hemofiltration (CVVH) caused a prompt decrease of the toxic metabolite levels as well as an improvement of the patient's condition. PMID:20309789

Thimm, E; Hadzik, B; Höhn, T

2010-03-22

306

Interleukin-17 synergizes with IFN? or TNF? to promote inflammatory mediator release and intercellular adhesion molecule-1 (ICAM-1) expression in human intervertebral disc cells  

PubMed Central

Interleukin-17 (IL-17) is a cytokine recently shown to be elevated, along with interferon-? (IFN?) and tumor necrosis factor (TNF?), in degenerated and herniated intervertebral disc (IVD) tissues, suggesting a role for these cytokines in intervertebral disc disease. The objective of our study was to investigate the involvement of IL-17 and costimulants IFN? and TNF? in intervertebral disc pathology. Cells were isolated from anulus fibrosus and nucleus pulposus tissues of patients undergoing surgery for intervertebral disc degeneration or scoliosis. The production of inflammatory mediators, nitric oxide (NOx), prostaglandin E2 (PGE2) and interleukin-6 (IL-6), as well as intercellular adhesion molecule (ICAM-1) expression, were quantified for cultured cells following exposure to IL-17, IFN? and TNF?. Intervertebral disc cells exposed to IL-17, IFN? or TNF? showed a remarkable increase in inflammatory mediator release and ICAM-1 expression (GLM and ANOVA, p<0.05). Addition of IFN? or TNF? to IL-17 demonstrated a synergistic increase in inflammatory mediator release, and a marked increase in ICAM-1 expression. These findings suggest that IVD cells not only respond with a catabolic phenotype to IL-17 and costimulants IFN? and TNF?, but also express surface ligands with consequent potential to recruit additional lymphocytes and immune cells to the IVD microenvironment. IL-17 may be an important regulator of inflammation in the IVD pathologies.

Gabr, Mostafa A.; Jing, Liufang; Helbling, Antonia R.; Sinclair, S. Michael; Allen, Kyle D.; Shamji, Mohammed F.; Richardson, William J.; Fitch, Robert D.; Setton, Lori A.; Chen, Jun

2010-01-01

307

Peripheral Disc Margin Shape and Internal Disc Derangement: Imaging Correlation in Significantly Painful Discs Identified at Provocation Lumbar Discography  

PubMed Central

Summary Annular margin shape is used to characterize lumbar disc abnormality on CT/MR imaging studies. Abnormal discs also have internal derangement including annular degeneration and radial defects. The purpose of this study was to evaluate potential correlation between disc-margin shape and annular internal derangement on post-discogram CT in significantly painful discs encountered at provocation lumbar discography (PLD). Significantly painful discs were encountered at 126 levels in 86 patients (47 male, 39 female) studied by PLD where no prior surgery had been performed and response to intradiscal lidocaine after provocation resulted in either substantial/total relief or no improvement after lidocaine administration. Post-discogram CT and discogram imaging was evaluated for disc-margin characteristics (bulge/protrusion), features of disc internal derangement (radial annular defect [RD: radial tear/fissure/annular gap], annular degeneration) and presence/absence of discographic contrast leakage. In discs with focal protrusion, 50 of 63 (79%) demonstrated Grade 3 RD with 13 (21%) demonstrating severe degenerative change only. In discs with generalized-bulge-only, 48 of 63 (76%) demonstrated degenerative change only (primarily Dallas Grade 3) with 15 of 63 (24%) demonstrating a RD (Dallas Grade 3). Differences were highly statistically significant (p<0.001). Pain elimination with intra-discal lidocaine correlated with discographic contrast leakage (p<0.001). Disc-margin shape correlates with features of internal derangement in significantly painful discs encountered at PLD. Discs with focal protrusion typically demonstrate RD while generalized bulging discs typically demonstrated degenerative changes only (p<0.001). Disc-margin shape may provide an important imaging clue to the cause of chronic discogenic low back pain.

Bartynski, W.S.; Rothfus, W.E.

2012-01-01

308

Peripheral disc margin shape and internal disc derangement: imaging correlation in significantly painful discs identified at provocation lumbar discography.  

PubMed

Annular margin shape is used to characterize lumbar disc abnormality on CT/MR imaging studies. Abnormal discs also have internal derangement including annular degeneration and radial defects. The purpose of this study was to evaluate potential correlation between disc-margin shape and annular internal derangement on post-discogram CT in significantly painful discs encountered at provocation lumbar discography (PLD). Significantly painful discs were encountered at 126 levels in 86 patients (47 male, 39 female) studied by PLD where no prior surgery had been performed and response to intradiscal lidocaine after provocation resulted in either substantial/total relief or no improvement after lidocaine administration. Post-discogram CT and discogram imaging was evaluated for disc-margin characteristics (bulge/protrusion), features of disc internal derangement (radial annular defect [RD: radial tear/fissure/annular gap], annular degeneration) and presence/absence of discographic contrast leakage. In discs with focal protrusion, 50 of 63 (79%) demonstrated Grade 3 RD with 13 (21%) demonstrating severe degenerative change only. In discs with generalized-bulge-only, 48 of 63 (76%) demonstrated degenerative change only (primarily Dallas Grade 3) with 15 of 63 (24%) demonstrating a RD (Dallas Grade 3). Differences were highly statistically significant (p<0.001). Pain elimination with intra-discal lidocaine correlated with discographic contrast leakage (p<0.001). Disc-margin shape correlates with features of internal derangement in significantly painful discs encountered at PLD. Discs with focal protrusion typically demonstrate RD while generalized bulging discs typically demonstrated degenerative changes only (p<0.001). Disc-margin shape may provide an important imaging clue to the cause of chronic discogenic low back pain. PMID:22681741

Bartynski, W S; Rothfus, W E

2012-06-04

309

Expression of silent mating type information regulator 2 homolog 1 and its role in human intervertebral disc cell homeostasis  

PubMed Central

Introduction Intervertebral disc tissue homeostasis is modulated by a variety of molecules. Silent mating type information regulator 2 homolog 1 (SIRT1) plays a key role in various physiological processes. The aim of the present study was to verify the expression of SIRT1 and determine SIRT1 function in human intervertebral disc cell homeostasis. Methods Human nucleus pulposus (NP) cells were obtained from 24 surgical patients (mean age: 39.4 years) and monolayer-cultured. SIRT1 expression was investigated using RT-PCR analysis and immunohistochemical staining. Quantitative real-time RT-PCR was performed to detect mRNA expression of SIRT1 and other genes: aggrecan, collagen type 2 and Sox9. The effect of SIRT1 on the extracellular matrix metabolism of NP cells was examined using recombinant human SIRT1 protein and a protein delivery reagent. Cell number and proliferation activity were measured following SIRT1 treatment. To reveal the deacetylation potential of transfected recombinant human SIRT1, western blotting for acetylated p53 was utilized. R-phycoerythrin was used for the negative control. Results SIRT1 expression was confirmed at both mRNA and protein levels in almost all NP cells. Real-time RT-PCR analysis showed SIRT1 mRNA expression significantly increased with donor age (P <0.05, ? = 0.492). Pfirrmann grade 3 discs showed significantly higher SIRT1 mRNA expression than other grades. SIRT1 treatment significantly reduced aggrecan, Sox9 and collagen type 2 mRNA expression in a dose-dependent manner in all disease classes and disc degeneration grades. Proliferation activity was decreased by SIRT1 treatment in lumbar spinal stenosis and lumbar disc herniation, Pfirrmann grade 3 and grade 4 discs. In contrast, it was significantly upregulated in idiopathic scoliosis, Pfirrmann grade 2 discs. The negative control protein did not affect extracellular matrix metabolism or proliferation activity. Conclusions We demonstrate for the first time that SIRT1 is expressed by human NP cells. SIRT1 expression was significantly elevated in an early degeneration stage. SIRT1 affected both extracellular matrix metabolism and proliferation activity; the effect of SIRT1 was altered according to disease class and disc degeneration grade. SIRT1 appears to play a key role in homeostasis during the human intervertebral disc degeneration process.

2011-01-01

310

Vacuuming radioactive sludge  

ScienceCinema

Vacuuming an estimated 55 cubic yards of radioactive sludge from the floor of Hanford's K East Basin was a complicated process. Workers stood on grates suspended above the 20-foot deep basin and manipulated vacuuming equipment at the end of long poles--using underwater cameras to guide their work.

311

Working in a Vacuum  

ERIC Educational Resources Information Center

|In this article, the author discusses several myths about vacuum cleaners and offers tips on evaluating and purchasing this essential maintenance tool. These myths are: (1) Amps mean performance; (2) Everyone needs high-efficiency particulate air (HEPA): (3) Picking up a "bowling ball" shows cleaning power; (4) All vacuum bags are the same; (5)…

Rathey, Allen

2005-01-01

312

Vacuum technology for ITER  

Microsoft Academic Search

The vacuum systems for ITER are characterized by the requirements for tritium compatibility, tolerance of high magnetic and radiation fields and remote maintainability. In addition, although the vacuum levels are relatively modest, high pumping speeds are needed to achieve the high gas throughputs required. The design solutions adopted, the status of the development programme and the issues still to be

D. Murdoch; A. Antipenkov; C. Caldwell-Nichols; C. Day; M. Dremel; H. Haas; V. Hauer; H. Jensen

2008-01-01

313

The ITER vacuum systems  

Microsoft Academic Search

ITER is a large vacuum facility which comprises many service, diagnostic and monitoring vacuum sub-systems as well as three large cryogenic pumping systems for evacuation and maintenance of the required pressure levels. Control of the gas throughput is one of the key issues affecting the performance and achievable burn time of a fusion reactor. The main pumping systems are the

C. Day; D. Murdoch

2008-01-01

314

Vacuum driven accelerated expansion  

Microsoft Academic Search

It has been shown that an improved estimation of quantum vacuum energy can yield not only acceptable but also experimentally sensible results. The very idea consists in a straightforward extraction of gravitationally interacting part of the full quantum vacuum energy by means of gauge transformations. The implementation of the idea has been performed in the formalism of effective action, in

B. Broda; P. Bronowski; Marcin Ostrowski; Micha? Szanecki

2008-01-01

315

Architecture and applications of generic disc  

NASA Astrophysics Data System (ADS)

The generic disc defines a data structure in which the data content stored on the disc is not limited to a particular data type or encoding scheme or the physical format of the optical media. This is achieved by making the logical layer of the disc independent from the physical layer of the disc. In this way, different types of content and different applications related to this content can co-exist on the same optical disc and interact with each other, independent of the physical format of the disc. This paper gives a brief introduction of the generic disc concept in the introduction section. Then a detailed description of the system architecture, software architecture, player flowchart and application software flowchart are provided in the rest of this paper.

Wang, Michelle; Kim, Sheng; Wei, Gongming

2004-09-01

316

Integrated-optic disc pickups  

NASA Astrophysics Data System (ADS)

The present status of waveguide-type integrated-optic disc pickups are reviewed. The authors have proposed and fabricated several types, and have demonstrated their fundamental functions. For the ROM pickup, they successfully reduced the focused spot to a diameter that is slightly larger than the diffraction-limited value, and confirmed capability of the focusing/tracking error signal detection. The pickup was extended to that for magneto-optical (MO) disc system, and the MO pickup was found experimentally to detect a polarization rotation as small as one contained in the signal beam reflected from MO medium. The pickup for parallel-data cards was also fabricated with photodiode array, and seven-track parallel readout was demonstrated. It was found by theoretical analysis that the waveguide-FGC combined type pickup has the possibility of super-resolution readout.

Nishihara, Hiroshi; Suhara, Toshiaki; Ura, Shogo

1992-08-01

317

Papilledema and optic disc pit: The association of two pathologies in one patient.  

PubMed

Histologically, optic disc pit (ODP) is described as a small congenital defect in the cribriform plate where a herniation of the dysplastic retina extends to the subarachnoid space in the optic nerve, which is surrounded by a layer of collagen-rich tissue. Approximately 25-75% of cases are complicated by optic disc pit maculopathy (ODPM). The pathogenesis of maculopathies associated with ODP has not been fully elucidated. We present an unusual case of a patient with a history of papilledema secondary to a fronto-temporal meningioma. The patient underwent a successful surgical intervention with resolution of the papilledema 15 years before the detection of an ODP that was associated with retinal detachment in the macular region. Several studies have reported on the importance of intracranial pressure in the development of maculopathies associated with ODP. During the period of intracranial hypertension and papilledema in our patient, the hernia sac that was associated with ODP may have been small, which would have decreased the chances of developing a maculopathy that was associated with OPD. PMID:23961031

Galvez-Ruiz, Alberto; Ghazi, Nicola; Ruhaily, Yasir

2012-10-01

318

Papilledema and optic disc pit: The association of two pathologies in one patient  

PubMed Central

Histologically, optic disc pit (ODP) is described as a small congenital defect in the cribriform plate where a herniation of the dysplastic retina extends to the subarachnoid space in the optic nerve, which is surrounded by a layer of collagen-rich tissue. Approximately 25–75% of cases are complicated by optic disc pit maculopathy (ODPM). The pathogenesis of maculopathies associated with ODP has not been fully elucidated. We present an unusual case of a patient with a history of papilledema secondary to a fronto-temporal meningioma. The patient underwent a successful surgical intervention with resolution of the papilledema 15 years before the detection of an ODP that was associated with retinal detachment in the macular region. Several studies have reported on the importance of intracranial pressure in the development of maculopathies associated with ODP. During the period of intracranial hypertension and papilledema in our patient, the hernia sac that was associated with ODP may have been small, which would have decreased the chances of developing a maculopathy that was associated with OPD.

Galvez-Ruiz, Alberto; Ghazi, Nicola; Ruhaily, Yasir

2012-01-01

319

The prognosis of self-reported paresthesia and weakness in disc-related sciatica.  

PubMed

PURPOSE: To explore how patients with sciatica rate the 'bothersomeness' of paresthesia (tingling and numbness) and weakness as compared with leg pain during 2 years of follow-up. METHODS: Observational cohort study including 380 patients with sciatica and lumbar disc herniation referred to secondary care. Using the Sciatica Bothersomeness Index paresthesia, weakness and leg pain were rated on a scale from 0 to 6. A symptom score of 4-6 was defined as bothersome. RESULTS: Along with leg pain, the bothersomeness of paresthesia and weakness both improved during follow-up. Those who received surgery (n = 121) reported larger improvements in both symptoms than did those who were treated without surgery. At 2 years, 18.2 % of the patients reported bothersome paresthesia, 16.6 % reported bothersome leg pain, and 11.5 % reported bothersome weakness. Among patients with no or little leg pain, 6.7 % reported bothersome paresthesia and 5.1 % bothersome weakness. CONCLUSION: During 2 years of follow-up, patients considered paresthesia more bothersome than weakness. At 2 years, the percentage of patients who reported bothersome paresthesia was similar to the percentage who reported bothersome leg pain. Based on patients' self-report, paresthesia and weakness are relevant aspects of disc-related sciatica. PMID:23771579

Grøvle, L; Haugen, A J; Natvig, B; Brox, J I; Grotle, M

2013-06-17

320

Percutaneous disc decompression using coblation (nucleoplasty) in the treatment of chronic discogenic pain.  

PubMed

Clinical outcome data was analyzed for 67 patients with contained disc herniation who underwent percutaneous disc decompression procedure using Coblation(R) technology, also referred to as Nucleoplasty after failing to respond to conservative management. Patients presented with clinical symptoms of discogenic low back pain and/or leg pain and were not considered candidates for open surgery. Follow-up data was collected up to 12 months. Patient gender distribution was 70% female, 30% male, with a mean age of 44 years. The onset of the pain was predominantly of nontraumatic origin with an average duration of pain of 5.4 years ranging from 4 months to 29 years with history of previous surgical intervention in 13% of the patients. At 1 year, 80% of the patients demonstrated statistically significant improvement in numeric pain scores. Average pre-procedure pain level for all patients was reported as 6.8 while average pain level was 4.1 at the 12 month follow-up period. Statistically significant improvement was observed in 62%, 59%, and 60% of patients in sitting, standing, and walking ability at 12 months, respectively. The results of this analysis indicated that PDD using Coblation technology, also referred to as Nucleoplasty, is an effective procedure for patients presenting with discogenic back and/or leg pain who have failed conservative therapies and are not considered candidates for open surgical interventions. PMID:16902650

Singh, Vijay; Piryani, Chandur; Liao, Katherine; Nieschulz, Sarah

2002-07-01

321

Correction of true periorbital fat herniation in cosmetic lower lid blepharoplasty  

Microsoft Academic Search

The presence of puffy, baggy lower eyelids is one of the first signs of the aging face. Baggy eyelids can result from excessive eyelid skin, hypertrophied orbicularis muscle, and\\/or periorbital fat herniation. An exact diagnosis of which components are contributing to the problem must be made in the preoperative period so that proper correction can be made during surgery. The

Peter B. Fodor; M. Sachs; S. Bosniak

1987-01-01

322

Correction of true periorbital fat herniation in cosmetic lower lid blepharoplasty  

Microsoft Academic Search

The presence of puffy, baggy lower eyelids is one of the first signs of the aging face. Baggy eyelids can result from excessive eyelid skin, hypertrophied orbicularis muscle, and\\/or periorbital fat herniation. An exact diagnosis of which components are contributing to the problem must be made in the preoperative period so that proper correction can be made during surgery. The

Michael Evan Sachs; Stephen L. Bosniak

1986-01-01

323

Isolation of the Fourth Ventricle Causing Transtentorial Herniation: Neurosonographic Findings in Premature Infants  

Microsoft Academic Search

OBJECTIVE. Significant posthemorrhagic enlargement of the fourth ventricle occurs only in a small minority of patients. Although entrapment or isolation of any ventricle can occur, the fourth ventricle is the most common site. This study was undertaken to better understand enlargement of the fourth ventricle after intraventricular hemorrhage and the neurosonographic features of isolation and transtentorial herniation. MATERIALS AND METHODS.

Theodore R. Hall; Anna Choi; Dieter ScheIlinger; Edward G. Grant

324

Management of Herniated Intervertebral Disks during Saturation Dives: A Case Report. (Reannouncement with New Availability Information).  

National Technical Information Service (NTIS)

Stevens DM, Caras BG, Flynn ET, Dutka AJ, Thorp JW, Thalmann ED. Management of herniated intervertebral disks during saturation dives: a case report. Undersea Biomed Res 1992; 19(3):191-198. During research saturation dives at 5.0 and 5.5 atm abs, 2 diver...

D. M. Stevens B. G. Caras E. T. Flynn A. J. Dutka J. W. Thorp

1992-01-01

325

Tension arachnoid cyst causing uncal herniation in a 60 year old: a rare presentation.  

PubMed

Arachnoid cysts are congenital benign cysts accounting for approximately 1% of all intracranial mass lesions. Uncal herniation due to arachnoid cyst is a rare mode of presentation. It is hypothesized that only tension arachnoid cyst could cause the life-threatening condition that results from a progressive deterioration and worsening of a simple and usually congenital arachnoid cyst, associated with the formation of a "ball valve" at the point of an opening on the cyst wall. To-date only one case of an arachnoid cyst causing Uncal herniation has been reported to the best of our knowledge. We present a rare case of uncal herniation in a 60-year-old lady caused by a giant left temporal arachnoid cyst. She presented to us in emergency room after experiencing headaches since last one week followed by vomiting, seizures, and altered state of consciousness. She was operated immediately and marsupialization of the arachnoid cyst was performed. She showed good recovery. Although arachnoid cyst is a benign slowly growing pathology, it can lead to Uncal herniation as a "tension" arachnoid cyst, possible due to "ball-valve" mechanism. Elective treatment should be considered to prevent progressive significant enlargement of cyst. PMID:22483281

Tahir, Muhammad Zubair; Quadri, S A; Farooqui, Mudassir; Bari, Muhammad Ehsan; Di, Xiao

2012-03-01

326

Accretion discs trapped near corotation  

NASA Astrophysics Data System (ADS)

We show that discs accreting on to the magnetosphere of a rotating star can end up in a trapped state, in which the inner edge of the disc stays near the corotation radius, even at low and varying accretion rates. The accretion in these trapped states can be steady or cyclic; we explore these states over a wide range of parameter space. We find two distinct regions of instability: one related to the buildup and release of mass in the disc outside corotation, and the other to mass storage within the transition region near corotation. With a set of calculations over long time-scales, we show how trapped states evolve from both non-accreting and fully accreting initial conditions, and also calculate the effects of cyclic accretion on the spin evolution of the star. Observations of cycles such as found here would provide important clues on the physics of magnetospheric accretion. Recent observations of cyclic and other unusual variability in T Tauri stars (EXors) and X-ray binaries are discussed in this context.

D'Angelo, Caroline R.; Spruit, Hendrik C.

2012-02-01

327

Investigations of Pulsed Vacuum Gap.  

National Technical Information Service (NTIS)

Past research and the current status of understanding of electrical breakdown of vacuum is reviewed. This review includes DC, AC and pulsed vacuum gap breakdown. Measurements have been performed to determine the role of microparticles in pulsed vacuum gap...

J. E. Thompson T. S. Sudarshan J. M. Butner

1981-01-01

328

Macroscopic changes during negative pressure wound therapy of the open abdomen using conventional negative pressure wound therapy and NPWT with a protective disc over the intestines  

PubMed Central

Background Higher closure rates of the open abdomen have been reported with negative pressure wound therapy (NPWT) than with other wound management techniques. However, the method has occasionally been associated with increased development of fistulae. We have previously shown that NPWT induces ischemia in the underlying small intestines close to the vacuum source, and that a protective disc placed between the intestines and the vacuum source prevents the induction of ischemia. In the present study we compare macroscopic changes after 12, 24, and 48 hours, using conventional NPWT and NPWT with a protective disc between the intestines and the vacuum source. Methods Twelve pigs underwent midline incision. Six animals underwent conventional NPWT, while the other six pigs underwent NPWT with a protective disc inserted between the intestines and the vacuum source. Macroscopic changes were photographed and quantified after 12, 24, and 48 hours of NPWT. Results The surface of the small intestines was red and mottled as a result of petechial bleeding in the intestinal wall in all cases. After 12, 24 and 48 hours of NPWT, the area of petechial bleeding was significantly larger when using conventional NPWT than when using NPWT with the protective disc (9.7 ± 1.0 cm2 vs. 1.8 ± 0.2 cm2, p < 0.001, 12 hours), (14.5 ± 0.9 cm2 vs. 2.0 ± 0.2 cm2, 24 hours) (17.0 ± 0.7 cm2 vs. 2.5 ± 0.2 cm2 with the disc, p < 0.001, 48 hours) Conclusions The areas of petechial bleeding in the small intestinal wall were significantly larger following conventional NPWT after 12, 24 and 48 hours, than using NPWT with a protective disc between the intestines and the vacuum source. The protective disc protects the intestines, reducing the amount of petechial bleeding.

2011-01-01

329

Accretion discs with strong toroidal magnetic fields  

NASA Astrophysics Data System (ADS)

Simulations and analytic arguments suggest that the turbulence driven by magnetorotational instability (MRI) in accretion discs can amplify the toroidal (azimuthal) component of the magnetic field to a point at which magnetic pressure exceeds the combined gas + radiation pressure in the disc. Arguing from the recent analysis by Pessah & Psaltis, and other MRI results in the literature, we conjecture that the limiting field strength for a thin disc is such that the Alfvén speed roughly equals the geometric mean of the Keplerian speed and the speed of sound in gas. We examine the properties of such magnetically dominated discs, and show that they resolve a number of outstanding problems in accretion disc theory. The discs would be thicker than standard (Shakura-Sunyaev) discs at the same radius and accretion rate, and would tend to have higher colour temperatures. If they transport angular momentum according to an ? prescription, they would be stable against the thermal and viscous instabilities that are found in standard disc models. In discs fuelling active galactic nuclei, magnetic pressure support could also alleviate the restriction on accretion rate imposed by disc self-gravity.

Begelman, M. C.; Pringle, J. E.

2007-03-01

330

The Aerodynamics of a Flying Sports Disc  

NASA Astrophysics Data System (ADS)

The flying sports disc is a spin-stabilised axi-symmetric wing of quite remarkable design. A typical disc has an approximate elliptical cross-section and hollowed out under-side cavity, such as the Frisbee(TM) disc. An experimental study of flying disc aerodynamics, including both spinning and non-spinning tests, has been carried out in the wind tunnel. Load measurements, pressure data and flow visualisation techniques have enabled an explanation of the flow physics and provided data for free-flight simulations. A computer simulation that predicts free-flight trajectories from a given set of initial conditions was used to investigate the dynamics of a flying disc. This includes a six-degree of freedom mathematical model of disc flight mechanics, with aerodynamic coefficients derived from experimental data. A flying sports disc generates lift through forward velocity just like a conventional wing. The lift contributed by spin is insignificant and does not provide nearly enough down force to support hover. Without spin, the disc tumbles ground-ward under the influence of an unstable aerodynamic pitching moment. From a backhand throw however, spin is naturally given to the disc. The unchanged pitching moment now results in roll, due to gyroscopic precession, stabilising the disc in free-flight.

Potts, Jonathan R.; Crowther, William J.

2001-11-01

331

Testing protoplanetary disc dispersal with radio emission  

NASA Astrophysics Data System (ADS)

We consider continuum free-free radio emission from the upper atmosphere of protoplanetary discs as a probe of the ionized luminosity impinging upon the disc. Making use of previously computed hydrodynamic models of disc photoevaporation within the framework of extreme-ultraviolet (EUV) and X-ray irradiation, we use radiative transfer post-processing techniques to predict the expected free-free emission from protoplanetary discs. In general, the free-free luminosity scales roughly linearly with ionizing luminosity in both EUV- and X-ray-driven scenarios, where the emission dominates over the dust tail of the disc and is partial optically thin at cm wavelengths. We perform a test observation of GM Aur at 14-18 GHz and detect an excess of radio emission above the dust tail to a very high level of confidence. The observed flux density and spectral index are consistent with free-free emission from the ionized disc in either the EUV- or the X-ray-driven scenario. Finally, we suggest a possible route to testing the EUV- and X-ray-driven dispersal model of protoplanetary discs, by combining observed free-free flux densities with measurements of mass-accretion rates. On the point of disc dispersal one would expect to find an dot{M}_*^2 scaling with free-free flux in the case of EUV-driven disc dispersal or an dot{M}* scaling in the case of X-ray-driven disc dispersal.

Owen, James E.; Scaife, Anna M. M.; Ercolano, Barbara

2013-10-01

332

Vacuum deposition system  

SciTech Connect

The Physics Section vacuum deposition system is available for several types of thin film techniques. This vacuum evaporation system operates in the high vacuum range. The evaporation source is a resistive heating element, either a boat or a filament design. Coating is then line of sight from the source. Substrates to be coated can have a maximum diameter of 17 inches. At this time the variations in the thickness of the coatings can be controlled, by monitor, to within about 100 angstroms. The system diagrams follow the Operation Procedures and the Sample Coating Procedures provided in this document. 3 figs.

Austin, S.; Bark, D.

1990-05-31

333

Collapse of vacuum bubbles in a vacuum  

SciTech Connect

We revisit the dynamics of a false vacuum bubble in a background de Sitter spacetime. We find that there exists a large parameter space that allows the bubble to collapse into a black hole or to form a wormhole. This may have interesting implications for the creation of a baby universe in the laboratory, the string landscape where the bubble nucleation takes place among a plenitude of metastable vacua, and the inflationary physics.

Ng, Kin-Wang; Wang, Shang-Yung [Institute of Physics, Academia Sinica, Taipei, Taiwan 11529 (China); Department of Physics, Tamkang University, Tamsui, Taiwan 25137 (China)

2011-02-15

334

Vacuum Pump Explosion Study.  

National Technical Information Service (NTIS)

An investigation was made into explosions and backfires occurring in vacuum pumps used on Navy oxygen component test stands. Research and testing uncovered several fire and toxicity hazards on these pumps which carry gaseous oxygen flows. Corrective recom...

H. H. Yuen T. D. Weikel

1972-01-01

335

Magnetic field dragging in accretion discs  

NASA Astrophysics Data System (ADS)

Accretion discs are composed of ionized gas in motion around a central object. Sometimes, the disc is the source of powerful bipolar jets along its rotation axis. Theoretical models invoke the existence of a bipolar magnetic field crossing the disc and require two conditions to produce powerful jets: field lines need to be bent enough at the disc surface and the magnetic field needs to be close to equipartition. The work of Petrucci et al (2008) on the variability of X-ray binaries supposes that transitions between pure accretion phases and accretion-ejection phases are due to some variations of the disc magnetization. This rises the problem of the magnetic field dragging in accretion discs. We revisit the method developed by Lubow et al (1994) by including momentum and mass conservation equations in a time-dependent 1D MHD code.

de Guiran, R.; Ferreira, J.

2010-12-01

336

Vacuum Erection Devices  

Microsoft Academic Search

Vacuum erection devices (VEDs) are safe, effective treatments for erectile dysfunction with few side effects. Vacuum negative\\u000a pressure more than 100 mmHg causes a combination of arterial and venous blood to fill the corpora cavernosum. The use of an\\u000a elastic band to trap the blood within the penis allows sufficient rigidity for penetration. Devices approved by the Food and\\u000a Drug

Hunter Wessells

337

Transdural Nerve Rootlet Entrapment in the Intervertebral Disc Space through Minimal Dural Tear : Report of 4 Cases  

PubMed Central

Four patients underwent lumbar surgery. In all four patients, the dura was minimally torn during the operation. However, none exhibited signs of postoperative cerebrospinal fluid leakage. In each case, a few days after the operation, the patient suddenly experienced severe recurring pain in the leg. Repeat magnetic resonance imaging showed transdural nerve rootlets entrapped in the intervertebral disc space. On exploration, ventral dural tears and transdural nerve rootlet entrapment were confirmed. Midline durotomy, herniated rootlet repositioning, and ventral dural tear repair were performed, and patients' symptoms improved after rootlet repositioning. Even with minimal dural tearing, nerve rootlets may become entrapped, resulting in severe recurring symptoms. Therefore, the dural tear must be identified and repaired during the first operation.

Choi, Jeong Hoon; Jang, Jee-Soo; Lee, Dong Yeob

2013-01-01

338

Spectra of accretion discs around white dwarfs  

NASA Astrophysics Data System (ADS)

We present the spectra of accretion discs around white dwarfs calculated with an improved and updated version of Shaviv and Wehrse [Shaviv, G., Wehrse, R., 1991. A&A 251, 117] model. The new version includes line opacities and convective energy transport and can be used to calculate the spectra of hot discs in bright systems (nova-like variables or dwarf novae in outburst) as well as the spectra of cold accretion discs in quiescent dwarf novae.

Idan, Irit; Lasota, Jean-Pierre; Hameury, Jean-Marie; Shaviv, Giora

2008-05-01

339

Postoperative Urinary Retention Following Anterior Cervical Spine Surgery for Degenerative Cervical Disc Diseases  

PubMed Central

Background Postoperative urinary retention (POUR) may cause bladder dysfunction, urinary tract infection, and catheter-related complications. It is important to be aware and to be able to identify patients at risk of developing POUR. However, there has been no study that has investigated the incidence and risk factors for the development of POUR following anterior cervical spine surgery for degenerative cervical disc disease. Methods We included 325 patients (164 male and 161 female), who underwent anterior cervical spine surgery for cervical radiculopathy or myelopathy due to primary cervical disc herniation and/or spondylosis, in the study. We did not perform en bloc catheterization in our patients before the operation. Results There were 36 patients (27 male and 9 female) that developed POUR with an overall incidence of 11.1%. The mean numbers of postoperative in-and-out catheterizations was 1.6 times and mean urine output was 717.7 mL. Thirteen out of 36 POUR patients (36%) underwent indwelling catheterization for a mean 4.3 days after catheterization for in-and-out surgery, because of persisting POUR. Seven out of 36 POUR patients (19%) were treated for voiding difficulty, urinary tract irritation, or infection. Chi-square test showed that patients who were male, had diabetes mellitus, benign prostate hypertrophy or myelopathy, or used Demerol were at higher risk of developing POUR. The mean age of POUR patients was higher than non-POUR patients (68.5 years vs. 50.8 years, p < 0.01). Conclusions To avoid POUR and related complications as a result of anterior cervical spine surgery for degenerative cervical disc disease, we recommend that a catheter be placed selectively before the operation in at-risk patients, the elderly in particular, male gender, diabetes mellitus, benign prostate hypertrophy, and myelopathy. We recommend that Demerol not be used for postoperative pain control.

Jung, Hyun Ju; Kong, Chae-Gwan; Kim, Young-Yul; Park, Jangsu; Kim, Jong Bun

2013-01-01

340

Grain charging in protoplanetary discs  

NASA Astrophysics Data System (ADS)

Context. Recent work identified a growth barrier for dust coagulation that originates in the electric repulsion between colliding particles. Depending on its charge state, dust material may have the potential to control key processes towards planet formation such as magnetohydrodynamic (MHD) turbulence and grain growth, which are coupled in a two-way process. Aims: We quantify the grain charging at different stages of disc evolution and differentiate between two very extreme cases: compact spherical grains and aggregates with fractal dimension Df = 2. Methods: Applying a simple chemical network that accounts for collisional charging of grains, we provide a semi-analytical solution. This allowed us to calculate the equilibrium population of grain charges and the ionisation fraction efficiently. The grain charging was evaluated for different dynamical environments ranging from static to non-stationary disc configurations. Results: The results show that the adsorption/desorption of neutral gas-phase heavy metals, such as magnesium, effects the charging state of grains. The greater the difference between the thermal velocities of the metal and the dominant molecular ion, the greater the change in the mean grain charge. Agglomerates have more negative excess charge on average than compact spherical particles of the same mass. The rise in the mean grain charge is proportional to N1/6 in the ion-dust limit. We find that grain charging in a non-stationary disc environment is expected to lead to similar results. Conclusions: The results indicate that the dust growth and settling in regions where the dust growth is limited by the so-called "electro-static barrier" do not prevent the dust material from remaining the dominant charge carrier.

Ilgner, M.

2012-02-01

341

DSC Study of Collagen in Disc Disease  

PubMed Central

Differential scanning calorimetry (DSC) has been used to estimate the effect of disc disease on the collagen helix-coil transition and morphology for tissue extracted from patients during surgical operation. Forty discs were obtained from patients with degenerative disc disease undergoing surgery for low back pain. The patients were in the age between 20 and 70 years old. The specimens were kept wet during DSC experiment. The data allow the comparison between thermal stability of collagen tissue from healthy patients and from patients suffering from disc disease. In the paper the comparison between thermal helix-coil transition for collagen fibers from patients suffering from disc disease and collagen fibers from healthy organisms has been discussed. The heating rate has an influence on the position on denaturation temperatures of collagen in disc tissues. Higher helix-coil transition temperature of collagen in degenerated disc suggests that additional intermolecular cross linking of collagen fibers occurs. Denaturation temperatures of collagen in degenerated male disc possess smaller values than in female ones. Disc disease induces changes in collagen structure and leads to formation of additional crosslinks between collagen fibers.

Skrzynski, S.; Sionkowska, A.; Marciniak, A.

2009-01-01

342

Toxocariasis of the optic disc.  

PubMed

A healthy 46-year-old man presented with decreased vision in the right eye after ingestion of raw meat. On funduscopic examination, a cystic lesion was found on an edematous right optic disc with adjacent serous retinal detachment. Optical coherence tomography confirmed a peripapillary serous retinal detachment and a well-demarcated cystic lesion (200 × 200 × 500 ?m) in the right eye. The patient had moderate eosinophilia and was seropositive for anti-Toxocara IgG antibody. Diagnosed with ocular toxocariasis, he was treated with systemic corticosteroids and albendazole with improvement in vision and fundus appearance. PMID:23535570

Kim, Yong Joon; Moon, Chan Hee; Chang, Jee Ho

2013-06-01

343

Crown Gall Tumor Disc Bioassay  

PubMed Central

Seventeen samples consisting of purified compounds and various ethanol extracts from plant sources were tested for activity on the initiation of crown gall tumors on potato discs. The results demonstrated definite correlation between the ability of these samples to inhibit the formation of crown gall tumors and their activity on the P388 leukemia system in mice. Samples showing only cytotoxic effects in KB cell cultures did not affect tumor initiation in our system. The active materials had no effects on bacterial viability or on the ability of the bacteria to attach to a tumorbinding site.

Galsky, Alan G.; Wilsey, James P.; Powell, Richard G.

1980-01-01

344

Linear eigenvalue analysis of the disc-brake squeal problem  

Microsoft Academic Search

SUMMARY This paper presents a numerical method to calculate the unstable frequencies of a car disc brake and suggests a suitable analysis procedure. The stationary components of the disc brake are modelled using finite elements and the disc as a thin plate. The separate treatments of the stationary components and the rotating disc facilitate the modelling of the disc brake

Q. Cao; H. Ouyang; M. I. Friswell; J. E. Mottershead

2004-01-01

345

Vacuum Technology and Space Simulation  

Microsoft Academic Search

Market: Those involved in vacuum technology and complex vacuum facilities. While specific projects have changed in the 30 years since this book was first published, the need for large complex vacuum facilities has not. And despite new developments in pumping, measurement, and outgassing, this book will remain for many years to come the standard of practical vacuum operation.

D. J. Santeler; D. H. Hokeboer; D. W. Jones; F. Pagano

1993-01-01

346

System Study, Vacuum Sewage Collection.  

National Technical Information Service (NTIS)

An effectiveness/cost comparison was made between gravity sewer systems and vacuum sewer systems for use in Navy advanced bases. The vacuum systems considered were single pipe system where vacuum toilets are connected directly to a vacuum sewer while the ...

R. Waller C. W. Mallory

1971-01-01

347

R&D ERL: Vacuum  

Microsoft Academic Search

The ERL Vacuum systems are depicted in a figure. ERL has eight vacuum volumes with various sets of requirements. A summary of vacuum related requirements is provided in a table. Five of the eight volumes comprise the electron beamline. They are the 5-cell Superconducting RF Cavity, Superconducting e-gun, injection, loop and beam dump. Two vacuum regions are the individual cryostats

M. Mapes; L. Smart; D. Weiss; A. Steszyn; R. Todd

2010-01-01

348

Use of adipose stem cells and polylactide discs for tissue engineering of the temporomandibular joint disc  

PubMed Central

There is currently no suitable replacement for damaged temporomandibular joint (TMJ) discs after discectomy. In the present study, we fabricated bilayer biodegradable polylactide (PLA) discs comprising a non-woven mat of poly(L/D)lactide (P(L/D)LA) 96/4 and a P(L/DL)LA 70/30 membrane plate. The PLA disc was examined in combination with adipose stem cells (ASCs) for tissue engineering of the fibrocartilaginous TMJ disc in vitro. ASCs were cultured in parallel in control and chondrogenic medium for a maximum of six weeks. Relative expression of the genes, aggrecan, type I collagen and type II collagen present in the TMJ disc extracellular matrix increased in the ASC-seeded PLA discs in the chondrogenic medium. The hypertrophic marker, type X collagen, was moderately induced. Alcian blue staining showed accumulation of sulphated glycosaminoglycans. ASC differentiation in the PLA discs was close to that observed in pellet cultures. Comparison of the mRNA levels revealed that the degree of ASC differentiation was lower than that in TMJ disc-derived cells and tissue. The pellet format supported the phenotype of the TMJ disc-derived cells under chondrogenic conditions and also enhanced their hyalinization potential, which is considered part of the TMJ disc degeneration process. Accordingly, the combination of ASCs and PLA discs has potential for the development of a tissue-engineered TMJ disc replacement.

Maenpaa, Katja; Ella, Ville; Mauno, Jari; Kellomaki, Minna; Suuronen, Riitta; Ylikomi, Timo; Miettinen, Susanna

2010-01-01

349

Intervertebral Disc Cell Therapy for Regeneration: Mesenchymal Stem Cell Implantation in Rat Intervertebral Discs  

Microsoft Academic Search

This study explores the use of mesenchymal stem cells (MSCs) for intervertebral disc regeneration. We used an in vivo model to investigate the feasibility of exogenous cell delivery, retention, and survival in the pressurized disc space. MSC injection into rat coccygeal discs was performed using 15% hyaluronan gel as a carrier. Injections of gel with or without MSCs were performed.

Gwen Crevensten; Andrew J. L. Walsh; Dheera Ananthakrishnan; Paul Page; George M. Wahba; Jeffrey C. Lotz; Sigurd Berven

2004-01-01

350

Material processing with vacuum  

NASA Astrophysics Data System (ADS)

The use of controlled atmosphere, especially vacuum, is the integral part of much the materials processing effort involving special materials. The underlying reasons that warrant the presence of vacuum along with high temperatures in these processing schemes are rooted in the thermodynamic properties of the materials particularly in relation to their interaction with gases and other interstitials. Apart from this pressure is also a highly usable process parameter that can be tailored to establish the desired heterogeneous equilibrium, in turn determined by the material to be produced or process to be executed. The range and depth of vacuum metallurgy or vacuum materials processing is vast. The present paper covers a selection of materials processing activities that have been carried out in the Materials Group, BARC involving production of materials, their processing and also basic property determination. A range of vacuum and furnace systems have been used and the practice of designing the process from fundamentals and executing through various batch sizes, and the solution of issues involved are all covered.

Krishnamurthy, N.; Suri, A. K.

2008-05-01

351

ISABELLE vacuum systems  

SciTech Connect

The Intersecting Storage Accelerator (ISABELLE) consists of two rings having a circumference of 3.8 km each. In these rings superconducting magnets, held at 4 K, bend and focus the proton beam which is accelerated up to 400 GeV. Due to very different pressure requirements, ISABELLE has two completely independent vacuum systems. One, which operates at 1 x 10/sup -11/ Torr, provides a very clean environment for the circulating proton beam. Here only ion and titanium sublimation pumps are used to provide the vacuum. The other system maintains superconducting magnet vessels at a pressure below 1 x 10/sup -4/ Torr, since at this pressure the gas conduction becomes negligible. In this so-called insulating vacuum system, turbomolecular pumps pump the inadvertent small helium leaks. Other gases are cryocondensed on the cold surfaces of the cryogenic system. The basic element of ISABELLE known as Full Cell containing 45 meters of beam tube, 8 pumping stations, 8 superconducting magnets and complete instrumentation has been constructed, leak checked and tested. All design parameters have been achieved in both vacuum systems. The two vacuum systems are described with particular emphasis on the influence of superconducting magnets in the selection of materials and UHV components.

Halama, H J

1980-01-01

352

Effects of lumbar disk herniation on the careers of professional baseball players.  

PubMed

Outcomes after lumbar disk herniation in baseball athletes are currently unknown. It has been postulated that the repetitive torque-producing motions of a baseball player may have negative implications after a disk injury. Sixty-nine lumbar disk herniations (40 treated operatively, 29 nonoperatively) in 64 professional baseball players were identified, and important outcome measures including successful return to play, time to recovery, career longevity, and performance based on vital statistics to each position were documented. Ninety-seven percent of baseball athletes successfully returned to play at an average of 6.6 months after diagnosis. Athletes treated operatively required significantly more time to return to play than those managed nonoperatively (8.7 vs 3.6 months, respectively; P<.0001). PMID:22229920

Earhart, Jeffrey S; Roberts, David; Roc, Gilbert; Gryzlo, Stephen; Hsu, Wellington

2012-01-01

353

Patho-anatomy of Herniation of the Reticulum Through the Diaphragm in the Bovine  

PubMed Central

Dissection of embalmed and untreated water buffalo carcasses (n=10) revealed that hernias had occurred at the musculotendinous junction of the diaphragm, ventral to the foramen venae cavae and slightly lateral to the median plane. The diameter of the hernial ring varied from 7 cm to 20 cm. Herniation was more common in the right thoracic cavity with the reticulum firmly adherent to the hernia ring. Adhesions between the herniated portion of the reticulum and pleura, lung, pericardium or thoracic wall were present, while in a few cases thick fibrous tracts concealing metallic bodies were found. In two cases, involvement of esophageal groove with malalignment of cardia and reticulo-omasal opening was observed. Displacement and compression of the heart was observed in four animals. ImagesFigure 1.Figure 2.Figure 3.

Deshpande, K. S.; Krishnamurthy, D.; Nigam, J. M.; Sharma, D. N.

1981-01-01

354

Intradural disk herniation at L1-L2: report of two cases  

PubMed Central

Context Lumbar intradural disk herniation (IDH) is a rare but serious complication of spinal disk protrusions. Although the pathogenesis of lumbar IDH is still vague, it is believed to be associated with the adhesion of the posterior longitudinal ligament with the ventral wall of the dura. Diagnosis is still difficult despite current neuroradiologic imaging techniques. Findings Two women, ages 63 and 69 years, presented with recent exacerbation of back pain. In each case, imaging studies revealed a ventral herniated disk at L1–L2. Both patients underwent surgery and in both cases a hard mass was palpated through the dura. Both patients experienced immediate postoperative relief of back pain following surgery. One patient required fusion and postoperative rehabilitation; her neurologic deficit returned to baseline. Conclusion/clinical relevance Prompt surgical intervention is indicated for IDH; disk removal allows for symptomatic relief and minimization of neurologic deficit.

Arnold, Paul M.; Wakwaya, Yosafe T.

2011-01-01

355

Histology of herniations through the body wall and cuticle of zooplankton from the Laurentian Great Lakes.  

PubMed

Zooplankton of the Laurentian Great Lakes developed hernial protrusions whose gross appearance matches those on zooplankton described elsewhere in the world. We have carried out a histologic and cytologic analysis of the protrusions and found that they are composed of apparently degenerating or necrotic tissue(s) that has been expressed from the organism through the process of herniation. At their base the protrusions are continuous with viable tissue(s) within the organism through a fissure in the exoskeleton. Our observations lead us to suspect that these hernial protrusions are lethal. The development of such protrusions in zooplankton may be a worldwide phenomenon, but the cause of the herniation remains a mystery. PMID:11273690

Omair, M; Naylor, B; Jude, D J; Quddus, J; Beals, T F; Vanderploeg, H A

2001-02-01

356

21 CFR 866.1620 - Antimicrobial susceptibility test disc.  

Code of Federal Regulations, 2010 CFR

...2010-04-01 2010-04-01 false Antimicrobial susceptibility test disc. 866...Diagnostic Devices § 866.1620 Antimicrobial susceptibility test disc. (a) Identification. An antimicrobial susceptibility test disc...

2010-04-01

357

21 CFR 866.1620 - Antimicrobial susceptibility test disc.  

Code of Federal Regulations, 2010 CFR

...2009-04-01 2009-04-01 false Antimicrobial susceptibility test disc. 866...Diagnostic Devices § 866.1620 Antimicrobial susceptibility test disc. (a) Identification. An antimicrobial susceptibility test disc...

2009-04-01

358

Conjugate heat transfer on a non-isothermal rotating disc  

NASA Astrophysics Data System (ADS)

A derivation of the conjugation criterion for a rotating disc is reported. Characteristics of conjugate heat transfer on a single disc and in a cavity formed by two discs, one rotating and the other stationary, are analysed.

Mironova, M. V.; Kortikov, N. N.

2011-12-01

359

Thick gas discs in faint dwarf galaxies  

NASA Astrophysics Data System (ADS)

We determine the intrinsic axial ratio distribution of the gas discs of extremely faint MB < -14.5 dwarf irregular galaxies. We start with the measured (beam corrected) distribution of apparent axial ratios in the HI 21-cm images of dwarf irregular galaxies observed as part of the Faint Irregular Galaxy GMRT Survey (FIGGS). Assuming that the discs can be approximated as oblate spheroids, the intrinsic axial ratio distribution can be obtained from the observed apparent axial ratio distribution. We use a variety of methods to do this, and our final results are based on using Lucy's deconvolution algorithm. This method is constrained to produce physically plausible distributions, and also has the added advantage of allowing for observational errors to be accounted for. While one might a priori expect that gas discs would be thin (because collisions between gas clouds would cause them to quickly settle down to a thin disc), we find that the HI discs of faint dwarf irregulars are quite thick, with mean axial ratio ~ 0.6. While this is substantially larger than the typical value of ~0.2 for the stellar discs of large spiral galaxies, it is consistent with the much larger ratio of velocity dispersion to rotational velocity (?/vc) in dwarf galaxy HI discs as compared to that in spiral galaxies. Our findings have implications for studies of the mass distribution and the Tully-Fisher relation for faint dwarf irregular galaxies, where it is often assumed that the gas is in a thin disc.

Roychowdhury, Sambit; Chengalur, Jayaram N.; Begum, Ayesha; Karachentsev, Igor D.

2010-05-01

360

Fulda Gap Video Disc - A Tactical Decision.  

National Technical Information Service (NTIS)

My presentation describes a video disc based system which was developed to demonstrate potential applications as a tactical decision aid. It covers the creation of the video disc containing data for the Fluda Gap area of Germany, the system for exploitati...

K. M. Mattson R. B. Lambert

1986-01-01

361

Pressure transduction and fluid evacuation during conventional negative pressure wound therapy of the open abdomen and NPWT using a protective disc over the intestines  

PubMed Central

Background Negative pressure wound therapy (NPWT) has gained acceptance among surgeons, for the treatment of open abdomen, since very high closure rates have been reported with this method, compared to other kinds of wound management for the open abdomen. However, the method has occasionally been associated with increased development of fistulae. We have previously shown that NPWT induces ischemia in the underlying small intestines close to the vacuum source, and that a protective disc placed between the intestines and the vacuum source prevents the induction of ischemia. In this study we compare pressure transduction and fluid evacuation of the open abdomen with conventional NPWT and NPWT with a protective disc. Methods Six pigs underwent midline incision and the application of conventional NPWT and NPWT with a protective disc between the intestines and the vacuum source. The pressure transduction was measured centrally beneath the dressing, and at the anterior abdominal wall, before and after the application of topical negative pressures of -50, -70 and -120 mmHg. The drainage of fluid from the abdomen was measured, with and without the protective disc. Results Abdominal drainage was significantly better (p < 0. 001) using NPWT with the protective disc at -120 mmHg (439 ± 25 ml vs. 239 ± 31 ml), at -70 mmHg (341 ± 27 ml vs. 166 ± 9 ml) and at -50 mmHg (350 ± 50 ml vs. 151 ± 21 ml) than with conventional NPWT. The pressure transduction was more even at all pressure levels using NPWT with the protective disc than with conventional NPWT. Conclusions The drainage of the open abdomen was significantly more effective when using NWPT with the protective disc than with conventional NWPT. This is believed to be due to the more even and effective pressure transduction in the open abdomen using a protective disc in combination with NPWT.

2012-01-01

362

Delayed buccal fat pad herniation: An unusual complication of buccal flap in cleft surgery  

PubMed Central

Buccal musculomucosal flap is commonly used in cleft palate surgery for providing additional lining when nasal mucosa is inadequate. We report an unusual complication of progressively increasing fat herniation from the sutured donor site which started appearing on the third postoperative day. This necessitated excision of the protruding fat pad on the seventh postoperative day. The possible mechanism and precautions for prevention of this complication are discussed.

Tuli, Puneet; Parashar, Atul; Nanda, Vipul; Sharma, Ramesh K.

2009-01-01

363

Temporomandibular joint herniation into the external ear canal through foramen of Huschke.  

PubMed

Foramen of Huschke, which is also known as the foramen tympanicum, is an anatomical variation of the tympanic portion of the temporal bone. This foramen is located on the anteroinferior aspect of the external auditory canal, posteromedial to the temporomandibular joint. Herein, a rare case of foramen Huschke with a herniation of the soft tissues around the temporomandibular joint that result in severe otalgia and its treatment are presented. PMID:21316883

Akcam, Timur; Hidir, Yusuf; Ilica, A Turan; Kilic, Erbil; Sencimen, Metin

2011-02-12

364

Spontaneous dural tear leading to intracranial hypotension and tonsillar herniation in Marfan syndrome: a case report  

PubMed Central

Background We describe the case of a 38 year old male with Marfan syndrome who presented with orthostatic headaches and seizures. Case Presentation The patient was diagnosed with Spontaneous Intracranial Hypotension secondary to CSF leaks, objectively demonstrated by MR Myelogram with intrathecal contrast. Epidural autologus blood patch was administered at the leakage site leading to significant improvement. Conclusion Our literature search shows that this is the second reported case of a Marfan patient presenting with symptomatic spontaneous CSF leaks along with tonsillar herniation.

2010-01-01

365

Chiropractic rehabilitation of a patient with S1 radiculopathy associated with a large lumbar disk herniation  

Microsoft Academic Search

Objective: To describe the nonsurgical treatment of acute S1 radiculopathy from a large (12 × 12 × 13 mm) L5-S1 disk herniation. Clinical Features: A 31-year-old man presented with severe lower back pain and pain, paresthesia, and plantar flexion weakness of the left leg. His symptoms began 5 days before the initial visit and progressed despite nonsteroidal anti-inflammatory drugs and

Craig E. Morris

1999-01-01

366

Meningococcal Encephalitis associated with cerebellar tonsillar herniation and acute cervicomedullary injury.  

PubMed

A 13-year-old girl presented with a progressive ascending paralysis, bulbar dysfunction and finally respiratory arrest. Magnetic resonance (MR) showed acute cervicomedullary injury and hindbrain herniation. An emergency foramen magnum decompression and external ventricular drainage insertion were performed, and meningococcal infection was diagnosed. The patient recovered completely. Meningococcal encephalitis may have an atypical presentation, and a surgery can optimise the outcome. PMID:23391099

Fayeye, O; Pettorini, B L; Smith, M; Williams, H; Rodrigues, D; Kay, A

2013-02-01

367

Treatment of a symptomatic forearm muscle herniation with a wrap-around fascia lata graft  

Microsoft Academic Search

Muscle herniation in the extremity is a well-recognized cause of symptomatic pain on exertion. Only 17 cases involving the\\u000a upper limb has been previously described, 11 of them involving the anterior compartment of the forearm and only 2 were caused\\u000a by strenuous exertion. Treatment for this condition ranged from nonsurgical, primary closure with palmaris longus interweave,\\u000a formal fasciotomy, to closure

Kamarul A. Khalid; Edward T. Mah

2009-01-01

368

Unilateral inferior temporal lobectomy with hippocampectomy for relief of incisural herniation  

Microsoft Academic Search

Summary 1.The syndrome of incisural hippocampal herniation, accompanied by unilateral and then bilateral fixed pupils, deepening coma, respiratory irregularity (Cheyne-Stokes), contralateral hemiplegia, ipsilateral decerebrate posturing, rising blood pressure, and finally renal shutdown, indicates a terminal state that requires immediate relief.2.Accepted methods of relief by brain shrinkage, dexamethasone, subtemporal decompression, anterior temporal lobectomy, cutting of the tentorium, and even massive uncapping

W. B. Scoville; D. B. Bettis

1979-01-01

369

A method for quantitative measurement of lumbar intervertebral disc structures: an intra- and inter-rater agreement and reliability study  

PubMed Central

Background There is a shortage of agreement studies relevant for measuring changes over time in lumbar intervertebral disc structures. The objectives of this study were: 1) to develop a method for measurement of intervertebral disc height, anterior and posterior disc material and dural sac diameter using MRI, 2) to evaluate intra- and inter-rater agreement and reliability for the measurements included, and 3) to identify factors compromising agreement. Methods Measurements were performed on MRIs from 16 people with and 16 without lumbar disc herniation, purposefully chosen to represent all possible disc contours among participants in a general population study cohort. Using the new method, MRIs were measured twice by one rater and once by a second rater. Agreement on the sagittal start- and end-slice was evaluated using weighted Kappa. Length and volume measurements were conducted on available slices between intervertebral foramens, and cross-sectional areas (CSA) were calculated from length measurements and slice thickness. Results were reported as Bland and Altman’s limits of agreement (LOA) and intraclass correlation coefficients (ICC). Results Weighted Kappa (Kw (95% CI)) for start- and end-slice were: intra-: 0.82(0.60;0.97) & 0.71(0.43;0.93); inter-rater: 0.56(0.29;0.78) & 0.60(0.35;0.81). For length measurements, LOA ranged from [?1.0;1.0] mm to [?2.0;2.3] mm for intra-; and from [?1.1; 1.4] mm to [?2.6;2.0] mm for inter-rater. For volume measurements, LOA ranged from [?293;199] mm3 to [?582;382] mm3 for intra-, and from [?17;801] mm3 to [?450;713] mm3 for inter-rater. For CSAs, LOA ranged between [?21.3; 18.8] mm2 and [?31.2; 43.7] mm2 for intra-, and between [?10.8; 16.4] mm2 and [?64.6; 27.1] mm2 for inter-rater. In general, LOA as a proportion of mean values gradually decreased with increasing size of the measured structures. Agreement was compromised by difficulties in identifying the vertebral corners, the anterior and posterior boundaries of the intervertebral disc and the dural sac posterior boundary. With two exceptions, ICCs were above 0.81. Conclusions Length measurements and calculated CSAs of disc morphology and dural sac diameter from MRIs showed acceptable intra- and inter-rater agreement and reliability. However, caution should be taken when measuring very small structures and defining anatomical landmarks.

2013-01-01

370

Disc haemorrhages, precursors of open angle glaucoma.  

PubMed

In a long-term study of 1270 patients with at least one of the findings, open-angle glaucoma, disc haemorrhages or retinal vein occlusions, disc haemorrhages were witnessed in approximately 20% of the cases with open-angle glaucoma, and were a precursor of glaucomatous disc changes and associated visual field defects. Disc haemorrhages also preceded a rising intraocular pressure (IOP) in the destructive process among open-angle glaucoma cases. Similar glaucomatous development appears among cases independent of IOP or detection of exfoliation syndrome. Retinal vein occlusions and disc haemorrhages behave similarly with respect to glaucoma. The large number of transgressions is an argument against dividing glaucoma into different types. These findings support a vascular genesis to open-angle glaucoma, presented in earlier epidemiological studies. PMID:11906810

Sonnsjö, Bo; Dokmo, Yvonne; Krakau, Torsten

2002-01-01

371

Intervertebral disc cell therapy for regeneration: mesenchymal stem cell implantation in rat intervertebral discs.  

PubMed

This study explores the use of mesenchymal stem cells (MSCs) for intervertebral disc regeneration. We used an in vivo model to investigate the feasibility of exogenous cell delivery, retention, and survival in the pressurized disc space. MSC injection into rat coccygeal discs was performed using 15% hyaluronan gel as a carrier. Injections of gel with or without MSCs were performed. Immediately after injection, fluorescently labeled stem cells were visible on sections of cell-injected discs. Seven and 14 days after injection, stem cells were still present within the disc, but their numbers were significantly decreased. At 28 days, a return to the initial number of injected cells was observed, and viability was 100%. A trend of increased disc height compared to blank gel suggests an increase in matrix synthesis. The results indicate that MSCs can maintain viability and proliferate within the rat intervertebral disc. PMID:15095817

Crevensten, Gwen; Walsh, Andrew J L; Ananthakrishnan, Dheera; Page, Paul; Wahba, George M; Lotz, Jeffrey C; Berven, Sigurd

2004-03-01

372

Variability in digital analysis of optic disc topography  

Microsoft Academic Search

We determined the magnitude of variability in optic disc topographical parameters on digital analysis of the optic disc using the IS 2000. The variability introduced by the system, the observer, the observer and patient, and by clinically different types of discs was assessed in the measurement of the vertical cup-to-disc ratio, horizontal cup-to-disc ratio, cup area-to-disc area, cup volume, neuroretinal

Rohit Varma; William C. Steinmann; George L. Spaeth; Richard P. Wilson

1988-01-01

373

Vacuum-assisted delivery.  

PubMed

The literature seems to allow certain general conclusions regarding the choice of instrument for assisted vaginal delivery. Both forceps and vacuum extraction offer certain advantages and drawbacks. Forceps are more difficult to apply, more prone to potentially significant facial injuries, require generally better maternal analgesia, and are associated with increased maternal soft tissue trauma. Vacuum extractors in general are easier to apply, are more likely to result in scalp trauma, and may be associated with increased rates of intracranial trauma. It seems likely that factors particular to each patient may play a significant role in the genesis of delivery associated with maternal and neonatal morbidity. Because of the ease of application, vacuum extractors may be used potentially in circumstances in which forceps assistance would not be attempted, allowing an operator of average experience to perform rotational deliveries. The use of vacuum extraction does appear to decrease the incidence of cesarean section in delivery populations. Given the apparent association between difficult assisted deliveries and increased neonatal morbidity, it is incumbent on the operator to attempt delivery only when vaginal delivery seems to be a safe option. Furthermore, the operator in such circumstances must be willing to reassess the attempt if initial attempts are not met with success. The minimal rates of significant intracranial injury associated with vacuum extraction in randomized studies of the method demonstrate the relative safety of the vacuum extraction when used judiciously. The ultimate choice of the route of delivery and method of assisted delivery should reflect a consideration of the fetal station, presentation, and maternal and fetal circumstances. It is hoped that further investigations in this area may clarify some of the issues discussed in this article. PMID:8665766

Williams, M C

1995-12-01

374

Brain herniation in a patient with apparently normal intracranial pressure: a case report  

PubMed Central

Introduction Intracranial pressure monitoring is commonly implemented in patients with neurologic injury and at high risk of developing intracranial hypertension, to detect changes in intracranial pressure in a timely manner. This enables early and potentially life-saving treatment of intracranial hypertension. Case presentation An intraparenchymal pressure probe was placed in the hemisphere contralateral to a large basal ganglia hemorrhage in a 75-year-old Caucasian man who was mechanically ventilated and sedated because of depressed consciousness. Intracranial pressures were continuously recorded and never exceeded 17 mmHg. After sedation had been stopped, our patient showed clinical signs of transtentorial brain herniation, despite apparently normal intracranial pressures (less than 10 mmHg). Computed tomography revealed that the size of the intracerebral hematoma had increased together with significant unilateral brain edema and transtentorial herniation. The contralateral hemisphere where the intraparenchymal pressure probe was placed appeared normal. Our patient underwent emergency decompressive craniotomy and was tracheotomized early, but did not completely recover. Conclusions Intraparenchymal pressure probes placed in the hemisphere contralateral to an intracerebral hematoma may dramatically underestimate intracranial pressure despite apparently normal values, even in the case of transtentorial brain herniation.

2010-01-01

375

Intraoperative atelectasis due to endotracheal tube cuff herniation: a case report.  

PubMed

Endotracheal tube (ETT) cuff herniation is a rare, and often difficult to diagnose, cause of bronchial obstruction. We present a case of outside cuff herniation of an endotracheal tube that caused pulmonary right lung atelectasis. A 29-year-old man ,a case of car accident with multiple fractures, was admitted to the emergency ward and transferred to the operating room(OR) for open reduction and internal fixation (ORIF) of all fractures .The procedures were done under general anesthesia (G/A). The past medical history of the patient did not indicate any problem. Anesthesia was induced with thiopental, atracurium and then maintained by propofol and remifentanyl infusions and 100% O2 via orally inserted ETT. The patient was positioned in left lateral decubitus position for operation. Two hours after induction of anesthesia, the oxygen saturation level dropped to 85 % and the breath sounds in the right side of the chest were weakened. The chest x-ray images showed right lung atelectasis especially in the upper lobe. The problem was disappeared after removal of the ETT. In this case, we observed that an ETT cuff herniation can be a cause of airway obstruction. If there is a decreased unilateral breath sounds, we recommend replacement or repositioning of ETT. PMID:23165818

Moazeni Bitgani, Mohammad; Madineh, Hossein

2012-01-01

376

[Meningeal herniation associated to chronic otitis media in an otology center in the City of Mexico].  

PubMed

To assess the frequency and clinical characteristics of meningocele and meningoencephalocele into the middle ear, at an otological referral center of Mexico city. After analyzing 586 recordings of middle ear surgery, we identified that 3 (0.5%) had defects of the tegmen timpani, 2 had brain abscesses (0.34%) and 1 had (0.17%) a facial palsy. Two of the patients with defects of the tegmen timpani had herniation of the intracraneal tissue. Case 1. A 38 year old woman with a history of bilateral chronic otitis media, with 2 surgeries in the left ear. She was seeking medical care because of right hearing loss. However, computed tomography and magnetic resonance showed a defect of the tegmen timpani with temporal lobe herniation in the left ear. Case 2 was a 46 year old woman with no history of ear disease, just high blood pressure. She was seeking medical care because of right hearing loss, vertigo and headache. The clinical evaluation suggested tissue in the middle ear and the computed tomography showed a defect of the tegmen timpani, meningocele was confirmed by surgery. In the 2 patients the clinical characteristics did not suggest herniation of intracraneal tissue as the first diagnosis. This show us the importance of an intended evaluation and image studies to make an early diagnosis. PMID:16503034

Esparza Castro, M; Martínez Gutiérrez, N; Jáuregui Renaud, K

2006-01-01

377

Microsurgical management of the lumbar intervertebral disc-disease  

Microsoft Academic Search

One hundred consecutive patients operated on for sciatica pain using microsurgical techniques between April 1984 and February 1985 were evaluated retrospectively. This paper gives preoperative clinical data, end-result of surgery, rate of complications and true recurrent herniations.

Alpaslan Kulali; Klaus von Wild

1995-01-01

378

Vacuum pseudoscalar susceptibility  

SciTech Connect

We derive a novel model-independent result for the pion susceptibility in QCD via the isovector-pseudoscalar vacuum polarization. In the neighbourhood of the chiral limit, the pion susceptibility can be expressed as a sum of two independent terms. The first expresses the pion-pole contribution. The second is identical to the vacuum chiral susceptibility, which describes the response of QCD's ground state to a fluctuation in the current-quark mass. In this result one finds a straightforward explanation of a mismatch between extant estimates of the pion susceptibility.

Chang Lei [Institute of Applied Physics and Computational Mathematics, Beijing 100094 (China); Liu Yuxin [Department of Physics, Peking University, Beijing 100871 (China); State Key Laboratory of Nuclear Physics and Technology, Peking University, Beijing 100871 (China); Center of Theoretical Nuclear Physics, National Laboratory of Heavy Ion Accelerator, Lanzhou 730000 (China); Roberts, Craig D. [Department of Physics, Peking University, Beijing 100871 (China); Physics Division, Argonne National Laboratory, Argonne, Illinois 60439 (United States); Shi Yuanmei [Department of Physics, Nanjing Xiaozhuang College, Nanjing 211171 (China); Sun Weimin; Zong Hongshi [Department of Physics, Nanjing University, Nanjing 210093 (China); Joint Center for Particle, Nuclear Physics and Cosmology, Nanjing 210093 (China)

2010-03-15

379

Vacuum driven accelerated expansion  

NASA Astrophysics Data System (ADS)

It has been shown that an improved estimation of quantum vacuum energy can yield not only acceptable but also experimentally sensible results. The very idea consists in a straightforward extraction of gravitationally interacting part of the full quantum vacuum energy by means of gauge transformations. The implementation of the idea has been performed in the formalism of effective action, in the language of Schwinger's proper time and the Seeley-DeWitt heat kernel expansion, in the background of the Friedmann-Robertson-Walker geometry.

Broda, B.; Bronowski, P.; Ostrowski, M.; Szanecki, M.

2008-11-01

380

Structure and evolutionary history of DISC1.  

PubMed

Evolutionary and protein structural analyses can provide functional insights into genes implicated in human psychiatric diseases. Even eukaryotic organisms lacking nervous systems contain homologues of many key signalling molecules of animal neurons implying that human cognition derives, in part, from modifications of ancestral molecules and complexes. One protein whose evolutionary origin is obscure is DISC1 (disrupted in schizophrenia 1) whose gene locus has been associated with many psychiatric conditions including schizophrenia, clinical depression and bipolar disorder. This protein's rapid evolution and its unusual amino acid and ?-helix composition have hindered searches for DISC1 homologues in species other than vertebrates. Here, we review the evolution and structure of the DISC1 protein in the light of in-depth sequence analyses. These predict DISC1 orthologues in diverse eukaryotic organisms, including early-branching animals such as amphioxus, sea anemone, amoebas and Trichoplax, and in plants and algae. DISC1 thus is widespread among eukaryotes, although it remains absent from fungi, nematodes and Diptera, including fruit flies. These observations now permit studies of DISC1 function in simple non-vertebrate model organisms. Surprisingly, these analyses also identify between two and four sequence repeats in DISC1 orthologues. The first two of these repeats show significant sequence similarity to the UVR family of globular domains. These UVR-like repeats are predicted to contain, not coiled coil structures, but rather two closely associated antiparallel ?-helices. One common missense variant in DISC1 (L607F) lies within the second DISC1 UVR-like domain. These observations should assist in delineating the functional regions of the DISC1 protein. PMID:21852244

Sanchez-Pulido, Luis; Ponting, Chris P

2011-08-18

381

Simple discs with flat roatation curves  

NASA Astrophysics Data System (ADS)

The aim of this paper is to understand why the squared axial ratio of the velocity ellipse, ?phi_^2^/?_R_^2^, of old disc stars in the Galaxy is less than 1/2. To this end, two infinitesimally thin steady-state axisymmetric discs with asymptotically flat circular velocity curves are presented. The first model - which we designate the Rybicki disc has surface density decaying inversely with radius. The second model is Freeman's exponential disc, which is immersed in the gravity field of the halo simulated by Mestel's potential. For both discs, we provide an infinite family of simple distribution functions, which form a sequence of increasing pressure support. In the Rybicki disc, the stellar streaming velocity increases outwards with radius, which typically causes ?phi_^2^/?_R_^2^ to be greater than 1/2. For our exponential disc distribution functions, the stellar streaming velocity declines outwards with radius, which typically causes ?phi^2^/?_R_^2^ to be less than 1/2. Our exponential disc distribution functions have the property that ?_R_^2^ decays only inversely with galactocentric radius R. If the diminution is faster, the ratio ?phi_^2^/?_R_^2^ rises above 1/2 at the Sun as the mean streaming velocity declines only in the inner disk. To investigate this, exponential discs with exponentially falling radial velocity dispersion are built. These are in conflict with the observations on the axial ratio, even allowing for a mismatch in the photometric and kinematic scalelengths. There are a number of possible resolutions of the contradiction: (1) the galactic disc is not in a steady state or is non-axisymmetric; (2) the circular velocity curve is locally declining; (3) the description of all stellar populations by a single distribution function is invalid; (4) the radial velocity dispersion does not drop off exponentially fast, but much more slowly; (5) the sampling of moving clusters and transient associations of stars creates a biased data set.

Evans, N. W.; Collett, J. L.

1993-09-01

382

Quantum Vacuum Pathway Theory  

Microsoft Academic Search

It is theorized that the quantum vacuum is a random electromagnetic field that permeates the universe. It will be shown that acceleration between a quark and a random electromagnetic energy field is an analog of the reaction between a charge moving at constant velocity with respect to an organized electromagnetic field. The difference is that with a quark any natural

Eric John Habegger

2005-01-01

383

Vacuum Kundt waves  

NASA Astrophysics Data System (ADS)

We discuss the invariant classification of vacuum Kundt waves using the Cartan-Karlhede algorithm and determine the upper bound on the number of iterations of the Karlhede algorithm to classify the vacuum Kundt waves (Collins (1991 Class. Quantum Grav. 8 1859-69), Machado Ramos (1996 Class. Quantum Grav. 13 1589)). By choosing a particular coordinate system we partially construct the canonical coframe used in the classification to study the functional dependence of the invariants arising at each iteration of the algorithm. We provide a new upper bound, q ? 4, and show that this bound is sharp by analyzing the subclass of Kundt waves with invariant count beginning with (0, 1,…) to show that the class with invariant count (0, 1, 3, 4, 4) exists. This class of vacuum Kundt waves is shown to be unique as the only set of metrics requiring the fourth covariant derivatives of the curvature. We conclude with an invariant classification of the vacuum Kundt waves using a suite of invariants.

McNutt, David; Milson, Robert; Coley, Alan

2013-03-01

384

Electrospray deposition in vacuum  

Microsoft Academic Search

We have used the established technique of electrospray in developing a portable vacuum electrospray system which can deposit, in vacuo, dissolved molecules onto a sample which may then be analysed by UHV techniques. As an initial test of the system we have analysed silicon samples with an electrosprayed layer of poly(ethylene) oxide (PEO) using atomic force microscopy (AFM). The polymer

Janine C. Swarbrick; J. Ben Taylor; James N. O'Shea

2006-01-01

385

Vacuum System at IUAC  

NASA Astrophysics Data System (ADS)

Vacuum technology is an integral part of any accelerator system. At IUAC we have a 15UD PELLETRON, superconduting LINAC, Low Energy Ion beam Facility and a 1.7MV pelletron. Vacuum requirement in these accelerators is ~10-8 torr. Various types of Vacuum pump are used in different zones of the accelerators depending on load. Since the whole accelerator is quite long, distributed pumps are placed in different sections as per load. In ion sources displacement type pump viz turbo-pumps are usually used as the gas load is quite high. In other parts of the accelerator combination of getter and ion pumps are used. It is very much necessary to isolate different sections for maintenance purpose. Proper valves are used to isolate the sections and to avoid vacuum accidents proper interlock system is introduced. If air goes in some sections accidentally, valves will close automatically to protect other sections. The talk will cover different types of pumps and interlock used in accelerators at IUAC.

Mandal, A.

2012-11-01

386

Ultra high vacuum technology  

Microsoft Academic Search

A short introduction for some basic facts and equations. Subsquently, discussion about: Building blocks of an ultrahigh vacuum system - Various types of pumps required to reach uhv and methods to reduce these effects - Outgassing phenomena induced by the presence of a particle beam and the most common methods to reduce these effects It will be given some practical

Oswald Gröbner

2001-01-01

387

Langmuir vacuum and superconductivity  

NASA Astrophysics Data System (ADS)

It is shown that, in the "jelly" model of cold electron-ion plasma, the interaction between electrons and the quantum electromagnetic vacuum of Langmuir waves involves plasma superconductivity with an energy gap proportional to the energy of the Langmuir quantum.

Veklenko, B. A.

2012-06-01

388

Vacuum configurations for superstrings  

Microsoft Academic Search

We study candidate vacuum configurations in ten-dimensional O(32) and E8 × E8 supergravity and superstring theory that have unbroken N = 1 supersymmetry in four dimensions. This condition permits only a few possibilities, all of which have vanishing cosmological constant. In the E8 × E8 case, one of these possibilities leads to a model that in four dimensions has an

P. Candelas; Gary T. Horowitz; Andrew Strominger; Edward Witten

1985-01-01

389

Large Rotary Vacuum Seal  

Microsoft Academic Search

A seal is described which permits rotation of large circular sections or ; ports in the walls of a vacuum chamber. The seal is an unlubricated Tec-Ring (a ; Teflon O-ring with a core of rubber), and the friction is low even at large ; diameters. The behavior of such a seal is compared with that of a lubricated ;

D. E. Armstrong; Normand Blais

1963-01-01

390

Vacuum in Multicolor QCD.  

National Technical Information Service (NTIS)

It is assumed that among asymptotic solutions to the Makeenko-Migdal equation of the form exp(-aA - bL) (A = area, L = perimeter, A and L are large) there is also the solution which has asymptotic freedom at small distances. It is then shown that vacuum i...

P. Olesen

1980-01-01

391

Type D Vacuum Metrics  

Microsoft Academic Search

Using the Newman-Penrose formalism, the vacuum field equations are solved for Petrov type D. An exhaustive set of ten metrics is obtained, including among them a new rotating solution closely related to the Ehlers-Kundt ``C'' metric. They all possess at least two Killing vectors and depend only on a small number of arbitrary constants.

William Kinnersley

1969-01-01

392

Vacuum arc recovery phenomena  

Microsoft Academic Search

The present experimental and theoretical study has been designed to uncover the mechanism underlying the rapid recovery of electrical strength of a short vacuum gap after arcing. In the experiment the contacts were of gas-free silver and the contact area and gap length were varied. Recovery strength was measured following the forced extinction of a 250 amp arc in 0.5

J. A. Rich; G. A. Farrall

1964-01-01

393

Various unique vacuum holders  

SciTech Connect

Glassblowers use vacuum holding devices to support a flat plate in the glassflowing lathe to seal onto the end of, or inside of, a glass cylinder. Glassblowing blowhose swivels tend to leak; a rotating union from the hydraulics industry is better. Various graphite holder designs are described.

Gregar, J.S.

1992-12-01

394

Cryogenic vacuum pump design  

Microsoft Academic Search

This paper is a review of the problems and tradeoffs involved in cryogenic vacuum pump analysis, design and manufacture. Particular attention is paid to the several issues unique to cryopumps, e.g., radiation loading, adsorption of noncondensible gases, and regeneration. A general algorithm for cryopump design is also proposed.

A. J. Bartlett; P. A. Lessard

1984-01-01

395

The LHC Vacuum System  

Microsoft Academic Search

The Large Hadron Collider (LHC) at CERN, involves two proton storage rings with colliding beams of 7 TeV. The machine will be housed in the existing LEP tunnel and requires 16 m long superconducting b ending magnets. The vacuum chamber will be the inner wall of the cryostat and hence at the temperature of the magnet cold bore, i.e. at

Oswald Gröbner

1998-01-01

396

Electtra vacuum system  

Microsoft Academic Search

Elettra is a third-generation synchrotron light source which is being built especially for the use of high brilliance radiation from insertion devices and bending magnets. The UHV conditions in a storage ring lead to a longer beam lifetime-one of the most important criterion. The Elettra vacuum system presents some peculiarities which cannot be found in any already existing machine. The

M. Bernardini; F. Daclon; F. Giacuzzo; R. Kersevan; J. Miertusova; F. Pradal

1993-01-01

397

Vacuum insulator coating development  

Microsoft Academic Search

The authors discuss the electrical and mechanical requirements for vacuum insulators in high peak power generators. To increase the lifetime of these insulators, they have developed a coating called Dendresist. This coating has extended the insulator lifetime on the PITHON, DM2, CASINO, and Double-EAGLE pulsed power generators. They describe its development, and compare its electrical and mechanical strength to that

I. S. Roth; P. S. Sincerny; L. Mandelcorn; M. Mendelsohn; D. Smith; T. G. Engel; L. Schlitt; C. M. Cooke

1997-01-01

398

RF Vacuum Electronics.  

National Technical Information Service (NTIS)

We summarize our second quarter progress and discuss third quarter plans for the development of an edge emitter based vacuum triode with performance goals of 10 microA/micrometer emission current density at less than 250V and which can be modulated at1 GH...

D. Arch J. Holmen P. Bauhahn T. Akinwande T. Ohnstein

1992-01-01

399

Interpreting cosmological vacuum decay  

SciTech Connect

The cosmological vacuum decay scenario recently proposed by Wang and Meng [Classical Quantum Gravity 22, 283 (2005)] is rediscussed. From thermodynamic arguments it is found that the {epsilon} parameter quantifying the vacuum decay rate must be positive in the presence of particle creation. If there is no particle creation, the proper mass of Cold Dark Matter (CDM) particles is necessarily a time-dependent quantity, scaling as m(t)=m{sub o}a(t){sup {epsilon}}. By considering the presence of baryons in the cosmological scenario, it is also shown that their dynamic effect is to alter the transition redshift z{sub *} (the redshift at which the Universe switches from decelerating to accelerating expansion), predicting values of z{sub *} compatible with current estimates based on type Ia supernova. In order to constrain the {omega}{sub m}-{epsilon} plane, a joint statistical analysis involving the current supernovae observations, gas mass fraction measurements in galaxy clusters and CMB data is performed. At 95% c.l. it is found that the vacuum decay rate parameter lies on the interval {epsilon}=0.06{+-}0.10. The possibility of a vacuum decay into photons is also analyzed. In this case, the energy density of the radiation fluid scales as {rho}{sub r}={rho}{sub ro}a{sup -4+{epsilon}}, and its temperature evolution law obeys T(t)=T{sub o}a(t){sup {epsilon}}{sup /4-1}.

Alcaniz, J.S.; Lima, J.A.S. [Departamento de Astronomia, Observatorio Nacional, 20921-400 Rio de Janeiro - RJ (Brazil); Instituto de Astronomia, Geofisica e Ciencias Atmosfericas, USP, 05508-900 Sao Paulo, SP (Brazil)

2005-09-15

400

Triggered vacuum gaps  

Microsoft Academic Search

Characteristics of a sealed vacuum gap are described and the difficulties encountered in applying this gap as an overvoltage protection device are discussed. It is shown how these difficulties can be ameliorated by the use of gas-free electrode materials and by triggering the gap when breakdown is required. Several methods of triggering are discussed and some practical triggering devices are

J. M. Lafferty

1966-01-01

401

Tribological Behaviors at High Load of MoS 2 Films in Vacuum  

Microsoft Academic Search

\\u000a MoS2 films about 1?m in thickness have been deposited on 9Cr18 steel substrate disc with dimension of ?70mm×10mm by magnetron\\u000a sputtering method. The effect of high loads (15–50N) on tribological behaviors of the magnetron sputtered MoS2 films in vacuum was studied by pin-disc wear tests. The pins made with 2Cr13 steel were ?9mm×20mm and the leading portion\\u000a of them was

Xinxin Ma; Guangze Tang; Shiyu He; Gang Wang; Yong Liu; Dezhuang Yang

402

Nutrient supply and intervertebral disc metabolism.  

PubMed

The metabolic environment of disc cells is governed by the avascular nature of the tissue. Because cellular energy metabolism occurs mainly through glycolysis, the disc cells require glucose for survival and produce lactic acid at high rates. Oxygen is also necessary for cellular activity, although not for survival; its pathway of utilization is unclear. Because the tissues are avascular, disc cells depend on the blood supply at the margins of the discs for their nutrients. The nucleus and inner anulus of the disc are supplied by capillaries that arise in the vertebral bodies, penetrate the subchondral bone, and terminate at the bone-disc junction. Small molecules such as glucose and oxygen then reach the cells by diffusion under gradients established by the balance between the rate of transport through the tissue to the cells and the rate of cellular demand. Metabolites such as lactic acid are removed by the reverse pathway. The concentrations of nutrients farthest from the source of supply can thus be low; oxygen concentrations as low as 1% have been measured in the discs of healthy animals. Although gradients cannot be measured easily in humans, they can be calculated. Measured concentrations in surgical patients are in agreement with calculated values. PMID:16595440

Grunhagen, Thijs; Wilde, Geoffrey; Soukane, Dahbia Mokhbi; Shirazi-Adl, Saeed A; Urban, Jill P G

2006-04-01

403

ISAC target vacuum system  

SciTech Connect

The Isotope Separator and Accelerator (ISAC) facility at TRIUMF has been in full operation since 1999. The ISAC east and west targets use proton beam from the cyclotron to produce various radioactive isotopes, which are then ionized and extracted. The ions are then passed through the mass separator and selected ions are transferred to the low energy experiments or injected into a radio frequency quadrupole accelerator. The accompanying radioactive contamination from the production of radioactive ions requires a complex vacuum system. The main target vacuum space consists of two semiseparate (primary and secondary) volumes pumped by turbo-molecular pumps. The primary volume uses four pumps while the secondary volume uses two pumps. Two hermetic rotary vane pumps are used as backing pumps. The nominal vacuum in both volumes is about 1.33x10{sup -4} Pa (1.0x10{sup -6} Torr). The pressure is monitored by two cold cathode and two hot filament ion gauges. The cold cathode gauges are used to interlock the system, which is critical during the bake out of the target and beam production. The exhaust gas from the vacuum pumps can be radioactive. Three gas storage tanks (decay tanks) are used for temporary storage of the radioactive exhaust and its controlled release to the atmosphere. Gas-species insensitive membrane gauges are used for monitoring the pressure in the storage tanks. This article describes the details of the ISAC target vacuum system as well as some procedures related to the handling of the exhaust gas with traces of radioactive contamination produced by the targets.

Yosifov, Dimo; Sekachev, Igor [TRIUMF, Canada's National Laboratory for Particle and Nuclear Physics, Vancouver, British Columbia V6T 2A3 (Canada)

2006-07-15

404

Vacuum requirements for RHIC  

SciTech Connect

In this note the lifetime due to inelastic scattering of beam and residual gas ions is calculated in units of pressure (Torr). In addition, the transverse emittance growth due to elastic scattering is expressed in units of pressure. The definition of inelastic scattering includes both capture of an electron from a residual gas ion and central nuclear collisions between beam ion and gas atom. Emittance growth via elastic scattering is a simple consequence of multiple Coulomb scattering. Is is important to note that in an accelerator only the density of residual gas atoms is relevant to the machine operation. The measure of this density is the vacuum gauge, where this gauge is calibrated in pressure units at some known temperature T{sub G}. The vacuum unit or pressure is of course temperature dependent, and thus when quoting vacuum requirements for RHIC it is vital to state the temperature at which the pressure is computed. It might be necessary to scale any computed gas density to the pressure appropriate for the measurement with the vacuum gauge. Typically, the vacuum gauge operates at room temperature {approximately}300{degree}K. An explanation on how to rescale pressure as a function of temperature is given in the text. This note assumes the residual gas density in the so-called warm section (300{degree}K) of RHIC to be composed of 90% H{sub 2}, 5% CH{sub 4} and 5% CO. The gas in the cold section (5{degree}K) is assumed to be 100% He. The beam ions are taken to be {sup 197}Au{sup 79+}.

Rhoades-Brown, M.J.; Harrison, M.

1991-12-01

405

Demonstrations with a Vacuum: Old Demonstrations for New Vacuum Pumps.  

ERIC Educational Resources Information Center

|Explains mechanisms of 19th-century vacuum pumps. Describes demonstrations using the pump including guinea and feather tube, aurora tube, electric egg, Gassiots cascade, air mill, bell in vacuum, density and buoyancy of air, fountain in vacuum, mercury shower, palm and bladder glasses, Bacchus demonstration, pneumatic man-lifter, and Magdeburg…

Greenslade, Thomas B., Jr.

1989-01-01

406

Demonstrations with a Vacuum: Old Demonstrations for New Vacuum Pumps.  

ERIC Educational Resources Information Center

Explains mechanisms of 19th-century vacuum pumps. Describes demonstrations using the pump including guinea and feather tube, aurora tube, electric egg, Gassiots cascade, air mill, bell in vacuum, density and buoyancy of air, fountain in vacuum, mercury shower, palm and bladder glasses, Bacchus demonstration, pneumatic man-lifter, and Magdeburg…

Greenslade, Thomas B., Jr.

1989-01-01

407

Dynamical instabilities in disc-planet interactions  

NASA Astrophysics Data System (ADS)

Protoplanetary discs may become dynamically unstable due to structure induced by an embedded giant planet. In this thesis, I discuss the stability of such systems and explore the consequence of instability on planetary migration. I begin with non-self-gravitating, low viscosity discs and show that giant planets induce shocks inside its co-orbital region, leading to a profile unstable to vortex formation around a potential vorticity minimum. This instability is commonly known as the vortex or Rossby wave instability. Vortex-planet interaction lead to episodic phases of migration, which can be understood in the framework of type III migration. I then examine the effect of disc self-gravity on gap stability. The linear theory of the Rossby wave instability is extended to include disc gravity, which shows that self-gravity is effective at stabilising the vortex instability at small azimuthal wavenumber. This is consistent with the observation that more vortices develop with increasing disc mass in hydrodynamic simulations. Vortices in self-gravitating discs also resist merging, and is most simply understood as pair-vortices undergoing mutual horsehoe turns upon encounter. I show that in sufficiently massive discs vortex modes are suppressed. Instead, global spiral instabilities develop which are associated with a potential vorticity maximum at the gap edge. These edge modes can be physically understood as a result of unstable interaction between the gap edge and the exterior disc through gravity. I show the spiral arms can provide a positive torque on the planet, leading to fast migration outwards. I confirm the above results, obtained from razor-thin disc models, persist in three-dimensions.

Lin, Min-Kai

2012-03-01

408

Tritium handling in vacuum systems  

SciTech Connect

This report provides a course in Tritium handling in vacuum systems. Topics presented are: Properties of Tritium; Tritium compatibility of materials; Tritium-compatible vacuum equipment; and Tritium waste treatment.

Gill, J.T. [Monsanto Research Corp., Miamisburg, OH (United States). Mound Facility; Coffin, D.O. [Los Alamos National Lab., NM (United States)

1986-10-01

409

DISC1 genetics, biology and psychiatric illness  

PubMed Central

Psychiatric disorders are highly heritable, and in many individuals likely arise from the combined effects of genes and the environment. A substantial body of evidence points towards DISC1 being one of the genes that influence risk of schizophrenia, bipolar disorder and depression, and functional studies of DISC1 consequently have the potential to reveal much about the pathways that lead to major mental illness. Here, we review the evidence that DISC1 influences disease risk through effects upon multiple critical pathways in the developing and adult brain.

THOMSON, Pippa A.; MALAVASI, Elise L.V.; GRUNEWALD, Ellen; SOARES, Dinesh C.; BORKOWSKA, Malgorzata; MILLAR, J. Kirsty

2012-01-01

410

The patchy accretion disc in HT Cassiopeiae  

NASA Astrophysics Data System (ADS)

We reconstruct the temperatures and surface densities in the quiescent accretion disc in HT Cas by performing a Physical Parameter Eclipse Mapping analysis of archival UBVR observations. Using a simple hydrogen slab model and demanding a smooth, maximally artefact-free reconstruction, we derive a formal distance to HT Cas of 207+/-10pc, significantly larger than the 133+/-14pc we derive from a re-analysis of the data in the literature. The accretion disc is small (0.3-0.4R L1 ) and moderately optically thin, but becomes nearly optically thick near the white dwarf. The temperatures and surface densities in the disc range from 9500K and 0.013gcm-2 in the centre to about 4000K and 0.04gcm-2 at the disc edge. The mass-accretion rate in the disc is roughly constant but - at the derived distance - uncomfortably close to the rate that would prohibit the dwarf nova eruptions. We argue that the larger derived distance is probably incorrect but is not produced by inaccuracies in our spectral model or optimization method. The discrepancy can be resolved if the emission regions on the disc are patchy with a filling factor of about 40 per cent of the disc's surface. This solves the problem with the high effective temperatures in the disc - reducing them to around 6500K within a radius of 0.2R L1 - and reduces the derived temperature of the white dwarf and/or boundary layer from 22600 to 15500K. The viscosity parameters ? derived from all reconstructed temperatures and surface densities are of order 10-100 and cannot be lowered significantly by invoking a lower distance or the filling factor. This situation is easily explained using the same patchy nature of the emitting material, since the quiescent disc cannot consist of optically thin regions alone, but also of a dark and hence cold and dense disc which could easily contain most of the matter. If we require global values of ? of order 0.1, the implied total surface densities are 1-100gcm-2 - just like those expected for quiescent discs awaiting the next eruption. We discuss several possible sources of the chromospheric emission and its patchiness, including irradiation of the disc, thermal instabilities, spiral-wave-like global structures, and magnetically active regions associated with dynamo action and/or Balbus-Hawley instabilities.

Vrielmann, Sonja; Hessman, Frederic V.; Horne, Keith

2002-05-01

411

How Does Lumbar Degenerative Disc Disease Affect the Disc Deformation at the Cephalic Levels In Vivo?  

PubMed Central

Study Design Case-control study. Objective . To evaluate the effect of lumbar degenerative disc disease (DDD) on the disc deformation at the adjacent level and at the level one above the adjacent level during end ranges of lumbar motion. Summary of Background Data It has been reported that in patients with DDD, the intervertebral discs adjacent to the diseased levels have a greater tendency to degenerate. Although altered biomechanics have been suggested to be the causative factors, few data have been reported on the deformation characteristics of the adjacent discs in patients with DDD. Methods Ten symptomatic patients with discogenic low back pain between L4 and S1 and with healthy discs at the cephalic segments were involved. Eight healthy subjects recruited in our previous studies were used as a reference comparison. The in vivo kinematics of L3–L4 (the cephalic adjacent level to the degenerated discs) and L2–L3 (the level one above the adjacent level) lumbar discs of both groups were obtained using a combined magnetic resonance imaging and dual fluoroscopic imaging technique at functional postures. Deformation characteristics, in terms of areas of minimal deformation (defined as less than 5%), deformations at the center of the discs, and maximum tensile and shear deformations, were compared between the two groups at the two disc levels. Results In the patients with DDD, there were significantly smaller areas of minimal disc deformation at L3–L4 and L2–L3 than the healthy subjects (18% compared with 45% of the total disc area, on average). Both L2–L3 and L3–L4 discs underwent larger tensile and shear deformations in all postures than the healthy subjects. The maximum tensile deformations were higher by up to 23% (of the local disc height in standing) and the maximum shear deformations were higher by approximately 25% to 40% (of the local disc height in standing) compared with those of the healthy subjects. Conclusion Both the discs of the adjacent level and the level one above experienced higher tensile and shear deformations during end ranges of lumbar motion in the patients with DDD before surgical treatments when compared with the healthy subjects. The larger disc deformations at the cephalic segments were otherwise not detectable using conventional magnetic resonance imaging techniques. Future studies should investigate the effect of surgical treatments, such as fusion or disc replacement, on the biomechanics of the adjacent segments during end ranges of lumbar motion.

Wang, Shaobai; Xia, Qun; Passias, Peter; Li, Weishi; Wood, Kirkham; Li, Guoan

2013-01-01

412

The lower limits of disc fragmentation and the prospects for observing fragmenting discs  

NASA Astrophysics Data System (ADS)

A large fraction of brown dwarfs and low-mass hydrogen-burning stars may form by gravitational fragmentation of protostellar discs. We explore the conditions for disc fragmentation and find that they are satisfied when a disc is large enough (?100 au) so that its outer regions can cool efficiently, and it has enough mass to be gravitationally unstable, at such radii. We perform radiative hydrodynamic simulations and show that even a disc with mass 0.25 M? and size 100 au fragments. The disc mass, radius and the ratio of disc to star mass (MD/M?? 0.36) are smaller than in previous studies. We find that fragmenting discs drastically decrease in mass and size within a few 104 yr of their formation, since a fraction of their mass, especially outside ˜100 au is consumed by the new stars and brown dwarfs that form. Fragmenting discs end up with masses ˜0.001-0.1 M? and sizes ˜20-100 au. On the other hand, discs that are marginally stable evolve on a viscous time-scale, thus living longer (˜1-10 Myr). We produce simulated images of fragmenting discs and find that observing discs that are undergoing fragmentation is possible using current (e.g. IRAM Plateau de Bure interferometer) and future (e.g. ALMA) interferometers, but highly improbable due to the short duration of this process. Comparison with observations shows that many observed discs may be remnants of discs that have fragmented at an earlier stage. However, there are only a few candidates that are possibly massive and large enough to currently be gravitationally unstable. The rarity of massive (?0.2 M?), extended (?100 au) discs indicates that either such discs are highly transient (i.e. form, increase in mass becoming gravitationally unstable due to infall of material from the surrounding envelope and quickly fragment) or their formation is suppressed (e.g. by magnetic fields). We conclude that current observations of early-stage discs cannot exclude the mechanism of disc fragmentation.

Stamatellos, Dimitris; Maury, Anaëlle; Whitworth, Anthony; André, Philippe

2011-05-01

413

Vacuum Mechanisms of Nanoscale Precision  

Microsoft Academic Search

The principles of design of vacuum mechanims of nanoscale precision are presented. Physical basics of the mechanisms nanoscale\\u000a precision are discussed. Vacuum multicoordinate drives and manipulators are also shown.\\u000a \\u000a The analysis of vacuum technological equipment and vacuum research equipment shows that the most strict requirements for the\\u000a object transference are in electron beam micro lithography equipment. For example, electron beam

E. A. Deulin; V. P. Mikhailov; Yu. V. Panfilov; R. A. Nevshupa

414

A radiation hard vacuum switch  

DOEpatents

A vacuum switch with an isolated trigger probe which is not directly connected to the switching electrodes. The vacuum switch within the plasmatron is triggered by plasma expansion initiated by the trigger probe which travels through an opening to reach the vacuum switch elements. The plasma arc created is directed by the opening to the space between the anode and cathode of the vacuum switch to cause conduction. 3 figs.

Boettcher, G.E.

1988-07-19

415

Influence of high-permeability discs in an axisymmetric model of the Cadarache dynamo experiment  

NASA Astrophysics Data System (ADS)

Numerical simulations of the kinematic induction equation are performed on a model configuration of the Cadarache von-Kármán-sodium dynamo experiment. The effect of a localized axisymmetric distribution of relative permeability ?r that represents soft iron material within the conducting fluid flow is investigated. The critical magnetic Reynolds number Rmc for dynamo action of the first non-axisymmetric mode roughly scales like Rmc?r - Rmc???-1/2r, i.e. the threshold decreases as ?r increases. This scaling law suggests a skin effect mechanism in the soft iron discs. More important with regard to the Cadarache dynamo experiment, we observe a purely toroidal axisymmetric mode localized in the high-permeability discs which becomes dominant for large ?r. In this limit, the toroidal mode is close to the onset of dynamo action with a (negative) growth rate that is rather independent of the magnetic Reynolds number. We qualitatively explain this effect by paramagnetic pumping at the fluid/disc interface and propose a simplified model that quantitatively reproduces numerical results. The crucial role of the high-permeability discs in the mode selection in the Cadarache dynamo experiment cannot be inferred from computations using idealized pseudo-vacuum boundary conditions (H × n = 0).

Giesecke, A.; Nore, C.; Stefani, F.; Gerbeth, G.; Léorat, J.; Herreman, W.; Luddens, F.; Guermond, J.-L.

2012-05-01

416

VACUUM OSMOTIC DEHYDRATION OF FRUITS  

Microsoft Academic Search

Vacuum osmotic dehydration leads a special behaviour of mass transfer in fruit-sugar soluion system.Vacuum treatments intensify the capillary flow function and increase water transfer ratio.but have no significant influence on sugar uptake.Fruits such as pineapples which have higher porosity are more suitable to be treated under vacuum during the osmotic dehydration.

Xian Quan Shi; Pedro Fito Maupoey

1993-01-01

417

Surge-damping vacuum valve  

DOEpatents

A valve having a mechanism for damping out flow surges in a vacuum system which utilizes a slotted spring-loaded disk positioned adjacent the valve's vacuum port. Under flow surge conditions, the differential pressure forces the disk into sealing engagement with the vacuum port, thereby restricting the flow path to the slots in the disk damping out the flow surge.

Bullock, Jack C. (Pleasanton, CA); Kelly, Benjamin E. (Tracy, CA)

1980-01-01

418

Insertion device vacuum system designs  

SciTech Connect

Synchrotron light source insertion device vacuum systems now in operation and systems proposed for the future are reviewed. An overview of insertion devices is given and four generic vacuum chamber designs, transition section design and pumping considerations are discussed. Examples of vacuum chamber systems are presented.

Hoyer, E.

1988-05-01

419

Challenges For Vacuum Interrupter Design  

Microsoft Academic Search

Vacuum interrupters form the key component of a medium voltage (MV) vacuum switchgear design. Vacuum interrupter technology is now well established and key manufacturers across the world are routinely producing interrupters for ratings up to 52kVrms. Manufacturers have focused on reducing the cost of interrupter components by adapting to more efficient contact geometry, improved contact materials, finite element modelling for

R. Parashar; A. Baker; A. Sitzia

2006-01-01

420

Total disc replacement surgery for symptomatic degenerative lumbar disc disease: a systematic review of the literature  

Microsoft Academic Search

The objective of this study is to evaluate the effectiveness and safety of total disc replacement surgery compared with spinal\\u000a fusion in patients with symptomatic lumbar disc degeneration. Low back pain (LBP), a major health problem in Western countries,\\u000a can be caused by a variety of pathologies, one of which is degenerative disc disease (DDD). When conservative treatment fails,\\u000a surgery

Karin D. van den Eerenbeemt; Raymond W. Ostelo; Barend J. van Royen; Wilco C. Peul; Maurits W. van Tulder

2010-01-01

421

Vacuum chuck having vacuum-nipples wafer support  

US Patent & Trademark Office Database

A vacuum chuck is disclosed which has nipples as support structure and for vacuum delivery. In the preferred embodiment, two types of nipples are used: "plain" nipples which provide only support and vacuum nipples which provide support and deliver vacuum to retain the wafer on the chuck. The contact surface of the plain nipples is made smaller than that of the vacuum nipples. The chuck is secured to a stage using special supports which have limited flexibility in two axis with respect to the chuck, so as to prevent warping the chuck. Special vacuum nipples are disclosed which do not deliver vacuum unless the wafer exerts sufficient predetermined pressure on the nipple. The chuck is designed to hold both 200 mm and 300 mm wafers.

2001-07-10

422

Fas ligand plays an important role for the production of pro-inflammatory cytokines in intervertebral disc nucleus pulposus cells.  

PubMed

It is suggested that pro-inflammatory cytokines, which are produced by interaction of the intervertebral nucleus pulposus cells and macrophages, may be linked to the cause of pain of the intervertebral disc herniation. This study carries out the in vitro experiments to examine the mechanism, with the use of the co-culture of an immortalized cell line of nucleus pulposus of the human intervertebral disc and the macrophage cell line. As a result, it is found that the production of pro-inflammatory cytokines is significantly larger at the co-culture group than at the independent culture group. Also, at the co-culture group of macrophages and intervertebral nucleus pulposus cells with over-expression of fas ligand (FasL), the production of pro-inflammatory cytokines is found to be far larger. Furthermore, it is found that these pro-inflammatory cytokines are produced mainly by the intervertebral nucleus pulposus cells with over-expression of FasL, and that the expression of a disintegrin and metalloproteinase (ADAM) 10, which controls the expression of FasL and activates reverse signaling inside cells, also increases. From these findings, it is suggested that FasL and ADAM10 play an important role in the production of pro-inflammatory cytokines coming from interaction of the intervertebral nucleus pulposus cells and macrophages. PMID:23192951

Yamamoto, Junya; Maeno, Koichiro; Takada, Toru; Kakutani, Kenichiro; Yurube, Takashi; Zhang, Zhongying; Hirata, Hiroaki; Kurakawa, Takuto; Sakai, Daisuke; Mochida, Joji; Doita, Minoru; Kurosaka, Masahiro; Nishida, Kotaro

2012-11-28

423

New strategies for disc repair: novel preclinical trials  

Microsoft Academic Search

Degeneration of lumbar intervertebral discs is a major cause of low back complaints, an irreversible occurrence with no currently available treatment. Furthermore, various surgical procedures can accelerate disc degeneration. On the other hand, recent experimental studies on disc cells have demonstrated an important role for the nucleus pulposus in preserving overall disc structure. The author’s group has already found that

Joji Mochida

2005-01-01