An explicit and effective plan for evaluation of the failed back allows the diagnosis of nonorthopedic causes for low back pain, whether they be medical or psychosocial in nature. This plan includes the prompt recognition and treatment of those problems which are surgically remediable, such as the recurrent disk herniation or spinal stenosis. Finally, this plan will accurately define those patients for whom there is no cure at the present time, such as those with arachnoiditis and those with low back pain without a definable cause. Careful adherence to this plan will prevent the physician from advising these unfortunate patients who already suffered one unsuccessful operation from undergoing yet another futile exercise and yet not exclude those who will benefit from operative intervention.

Back Pain↗

PubMedDate not supplied

Metrizamide myelography and epidural venography. Their role in the diagnosis of lumbar disc herniation and spinal stenosis.

This study compares lumbar epidural venography with metrizamide (Amipaque) myelography as diagnostic modalities in the evaluation of lumbar disc herniation and spinal stenosis. The accuracy of epidural venography and metrizamide myelography was evaluated in 30 surgically confirmed cases of lumbar disc herniation and spinal stenosis to determine their relative diagnostic values. Sensitivities of epidural venography and metrizamide myelography were 83% and 97%, respectively, while the specificities were 88% and 100%, respectively. The conclusions of this study were: (1) The accuracy of metrizamide myelography exceeds that of epidural venography in the diagnosis of lumbar disc herniation and spinal stenosis. (2) Metrizamide myelography is indicated as the primary contrast technique in lumbar disc herniation and spinal stenosis. (3) Epidural venography is indicated as a secondary contrast technique in patients with a congenitally short or tapered dural sac.

Adult↗

PubMedDate not supplied

Cauda equina syndrome presenting as a herniated lumbar disk.

Cauda Equina Compression (CEC) is a clinical syndrome consisting of low back pain, bilateral sciatica, saddle anesthesia, bilateral lower extremity weakness, and even frank paraplegia with bowel and bladder incontinence. At the onset of CEC, the clinical picture may resemble typical intervertebral disk disease with low back pain and unilateral sciatica. The back pain is severe, overshadowing the leg pain, and should alert the physician to the periodic evaluation of the patient and evidence of a progressive neurologic deficit. Early discovery of CEC is necessary if neurologic recovery is to be expected from decompressive laminectomy.

Aged↗

PubMedDate not supplied

Femoral component implantation in uncemented THA.

Explore the source record for details and available documents.

Bone Cements↗