[Eight observations on the role of the intervertebral disks in painful syndromes of the lumbosacral joint. III. Lumbago; acute lumbago and intervertebral disks].
Explore the source record for details and available documents.
Back Pain↗
SEARCH · Search PubMed
Results for “INTERVERTEBRAL DISK”
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
The biomechanical significance of herniated lumbar intervertebral disk: a clinical comparison analysis of 22 multiple and 39 single segments in patients with lumbar intervertebral disk herniation.
OBJECTIVE: To analyze the clinical significance of herniated lumbar intervertebral nucleus pulposus (HNP) inside the spinal canal. STUDY DESIGN: This was a comparison study between patients with multiple lumbar disk herniation and those with single lumbar disk herniation receiving conservative treatment. METHODS: Four indices, including computed tomography, plain and dynamic radiology and quantified physical examinations, were compared among 22 consecutive patients with multiple disk protrusions and 37 with single disk protrusion before and after a period of conservative treatment, mainly using spinal manipulation. RESULTS: There were no obvious changes of HNP size, position and volume, even after clinical improvement. However, structural and functional recovery in the group with multiple segments was less satisfactory than that of the group with single segment involvement. CONCLUSIONS: The protruded disk tissue plays an important role in the biomechanical disturbances of the spinal column besides that of an irritating agent to nerve root(s).
Biomechanical Phenomena↗
[Transdural rupture of lumbar intervertebral disk prolapse].
Prolapses of intervertebral disks with intradural localisation are extremely rare. Up to 1981, a total of 41 cases have been published in the world literature. A report is given on two further patients in whom intradural sequesters of intervertebral disks were found during the operation. In one patiente there were at the same time two total intrathecal sequesters from the intervertebral spaces L 3/4 and L 4/5. Until now, no reports have been published on such cases in the world literature.
Cauda Equina↗
Herniation of calcified cervical intervertebral disk in children.
Childhood intervertebral disk calcification is a rare clinical entity and usually has a benign course, generally undergoing spontaneous resolution. However, rapid neurologic deterioration due to herniation, found in both of our cases of calcified cervical intervertebral disks, required urgent anterior discectomy and fusion, resulting in excellent recovery.
Adolescent↗
Intramedullary spinal cord damage associated with intervertebral disk material in a dog.
Intervertebral disk extrusions into the spinal cord are rarely reported in veterinary medicine, and only necropsy findings are described in previous reports. It is hypothesized that a disk lesion results in forceful injection of disk material into the spinal cord. In the 3-year-old Miniature Doberman Pinscher of our report, acute clinical signs and results of magnetic resonance imaging were consistent with this disease and helped determine the extent and character of the lesions. Alteration in the appearance of the nucleus pulposus was important in determining that intervertebral disk disease may have been present in this dog. However, a definitive diagnosis of intramedullary disk extrusion can be made only via histologic examination of a biopsy specimen or at necropsy. The dog improved substantially after surgical decompression of the spinal cord, and histologic findings in a biopsy specimen of material found within the spinal cord were consistent with mature degenerate intervertebral disk material.
Animals↗
[Function-related morphology of the intervertebral disks].
The intervertebral discs contribute to shock absorption only to a limited degree; they are important however, for efficient orientation of axial pressure transmission to the entire surface of the contiguous vertebral bodies. So long as there is sufficient distension of the nuclei pulposi, the annuli fibrosi (particularly those of the lumbar vertebral column) play a part in the ligamentous control of the motion segment. From the 20th year of life onwards the discs are completely avascular, although they show high metabolic turnover. Their water content decreases with advancing age. As early as the first decade of life, beginning in the lateral, uncovertebral zones, clefts appear in the cervical intervertebral discs. These clefts frequently progress to tears involving the whole of the intervertebral disc.
Adolescent↗
Intervertebral disk disease in 10 cats.
The medical records of 10 cats diagnosed with intervertebral disk disease were reviewed. No apparent sex or breed predilection was found. The mean age of cats in the study was 9.8 years. Clinical signs included back pain, difficulty ambulating, and incontinence. Radiographs revealed narrowed disk spaces, mineralized intervertebral disks, and evidence of extradural compression on myelography or computed tomography. All intervertebral disk herniations occurred in the thoracolumbar spine, with a peak incidence at the fourth to fifth lumbar (L4-L5) intervertebral disk space. Eight cats had Hansen's type I intervertebral disk herniation. Surgery was performed in seven cats. All cats judged to have an excellent outcome had undergone surgical decompression.
Animals↗
[Differential therapy of lumbar intervertebral disk protrusion].
Surgical treatment for protrusion of intervertebral disks in the lumbar region has been considerably optimised. Progress in imaging techniques has enabled representation and recording of intervertebral disk disorders at various pathogenetic stages. Backache has become endemic in industrial countries, in the course of time, and is often accompanied by pseudoradicular ischialgia. It is quite often uncritically attributed to intervertebral disk damage on the basis of findings recorded from computed tomography. With patients increasingly suffering pain, this has in many cases led to rash surgical decisions. -Principles of differential diagnosis by which the complexity of morphological findings underlying clinical symptoms is taken into due consideration are absolutely necessary to counter the above developments. Indications for neurosurgical differential therapy for protrusion of intervertebral disks at lumbar level should be individually established with due consideration of therapeutic procedures available and of the severity of complaints. The percutaneous and microsurgical techniques described in this paper are likely to suggest that procedures, such as hemilaminectomy and laminectomy are no longer justified unless exceptional cases are to be handled.
Humans↗
The canine intervertebral disk: part one: structure and function.
Intervertebral disk disease continues to be a common and debilitating condition of dogs. In the first of a two-part article on the canine intervertebral disk, the microscopic and ultrastructural anatomy of the normal, nonchondrodystrophoid disk is described. Specific attention is placed on elements of the structure which impart important functional attributes. Finally, the role of the intervertebral disk in providing flexibility to the vertebral column is discussed, with a description of its biomechanical properties and reaction to compressive loads.
Animals↗
Measuring diffusion of solutes into intervertebral disks with MR imaging and paramagnetic contrast medium.
BACKGROUND AND PURPOSE: Experimental studies have shown that solutes diffuse more slowly into degenerated intervertebral disks than into normal disks. A noninvasive clinical study of diffusion in intervertebral disks is not generally available. Our purpose was to evaluate contrast-enhanced MR images to study diffusion in normal and degenerated lumbar intervertebral disks. METHODS: The change in signal intensity (as a proportion of baseline signal intensity) was calculated in lumbar intervertebral disks on MR images obtained before and after injection of intravenous contrast medium in 15 patients with low back pain. The intervertebral disks were classified as normal or degenerated on the basis of the MR appearance. Postoperative disks and degenerative intervertebral disks with a "high-intensity zone" were excluded. The changes in signal intensity as a proportion of baseline signal intensity were compared in degenerated disks and normal disks and the differences tested for statistical significance. RESULTS: After intravenous administration of a gadolinium complex, signal intensity in normal intervertebral disks increased an average of 36% of baseline. In intervertebral disks with signs of degeneration, it increased an average of 21% of baseline. The difference was significant. CONCLUSION: The study shows that diffusion into normal human lumbar intervertebral disks can be evaluated with MR imaging combined with intravenous contrast medium. With suitable MR techniques, the relationship between diffusion and disk degeneration, and the effect of trauma, drugs, and nutrition on disk degeneration can be studied noninvasively.
Adult↗
Intramedullary intervertebral disk extrusion in a cat.
Intervertebral disk extrusion is rarely reported in the cat. In this case, the clinical, radiologic, and magnetic resonance imaging findings of an acute intramedullary intervertebral disk extrusion in a 5-year-old domestic shorthaired cat are described. Radiographically, there was mineralized disk material within the vertebral canal. On magnetic resonance images, the disk material was found to be within the spinal cord. A linear disk trail extending from the disk space into the spinal cord may be specific for intramedullary disk extrusion.
Animals↗
[Transthoracic decompression of the spinal cord in herniation of thoracic intervertebral disks].
Hemiation of the thoracic intervertebral disk is a rare pathology causing a severe neurological deficit. Of all the disk hernias, thoracic ones account for less than 1%. Thirty-five patients have been operated on for 12 years, by using the following methods: posterior approach (laminectomy) (n = 2), lateral extrapleural approach (n = 8), anterior (transthoracic) approach (n = 25). Out of the 35 patients operated on, there were 2 patients who felt worse after surgery via posterior approach, 6 patients had no changes, and positive changes were observed in 26 cases. For resection of hernias of the thoracic intervertebral disk, it is necessary to apply either transpleural (for Th(VI)-Th(XII) hernias) or lateral extrapleural (Th(I)-Th(VI)) approaches. Laminectomy is inadmissible.
Adult↗
The postoperative lumbar spine: enhanced MR evaluation of the intervertebral disk.
PURPOSE: To document the pattern of enhancement and morphologic changes on MR images that occur in the intervertebral disk and adjacent vertebral bodies after diskectomy and to correlate the presence of intervertebral disk enhancement with the preoperative and postoperative clinical findings. METHODS: Preoperatively, and at 3 months and 6 months after surgery, 94 adults who had first-time surgery for a herniated lumbar intervertebral disk that was associated with radiculopathy, expressed as leg symptoms or signs (with or without lower back pain), were asked to respond to a questionnaire regarding pain, were given serial physical examinations, and were examined with contrast-enhanced MR imaging. The measures of clinical outcome that were evaluated included the straight leg raise sign, radicular pain, and lower back pain. Type of disk herniation, intervertebral disk enhancement, disk space height, and degenerative end-plate changes were also assessed. RESULTS: Of the 94 patients evaluated, 19 (20%) had postoperative intervertebral disk enhancement that was not present on the preoperative study. The pattern of enhancement was remarkably consistent, with 18 of the cases showing linear enhancement within the intervertebral disk, manifested as two thin bands paralleling the end plates. End-plate enhancement was present in 7 (37%) of the 19 patients with disk enhancement. There were no significant associations between disk enhancement and specific clinical symptoms before or after surgery. CONCLUSION: Our group of asymptomatic postoperative patients had anular enhancement (curette site), disk enhancement, and vertebral end-plate enhancement on MR images without evidence of disk space infection. This finding points out the need to understand asymptomatic postoperative changes that are sequelae of surgery and not necessarily indicators of infection.
Adolescent↗
[Expression and distribution of xenoantigen alpha-Gal in intervertebral disk of Chinese banna minipig inbred line].
OBJECTIVE: To investigate the expression and distribution of xenoantigen in intervertebral disk of Chinese banna minipig inbred line, and to study the availability of xenograft transplantation of intervertebral disk. METHODS: Samples of intervertebral disk were collected from six Banna pigs of 8 to 11-month-old. The fixation, embedment and slice were performed. alpha-Gal specific binding lection (BSI-B4) were used as affinity reagents and affinity-immunohistochemistry assays (SABC methods and DAB stain) were conducted to detect the expression and distribution of xenoantigen (alpha-Gal). RESULTS: alpha-Gal was found in chondrocyte cell and chondrocyte-like cell in intervertebral disk which have the positive yellow-stained particulate aggradation. There was no stain in the matrix, elastic fiber and collagen fiber. CONCLUSIONS: The distribution of xenoantigen is locally in the tissue of intervertebral disk and its expression is weak. This suggests that the intervertebral disk of Banna pig may be alternative donor for xenotransplantation.
Animals↗
Cervical radiculopathy caused by neural foraminal migration of a herniated calcified intervertebral disk in childhood: a case report.
Childhood intervertebral disk calcification is a rare clinical entity. Although its clinical course is usually benign, nerve root irritation or spinal cord compression can occasionally occur. We present the clinical and radiologic findings of a 9-year-old boy with cervical radiculopathy due to a herniated calcified intervertebral disk, which developed suddenly after swimming for 1 hour. Radiologic findings indicated that a calcified nucleus pulposus at the C6-7 level herniated into the spinal canal and migrated far into the right C6-7 neural foramen. Surgical management was performed 8 weeks after the onset of symptoms, because the initial presenting symptoms persisted despite conservative treatment. In children, calcified intervertebral disks can cause cervical radiculopathy that requires surgical management when they herniate and migrate far into the neural foramen.
Calcinosis↗
[Computed tomography in the diagnosis of recurrent herniated disks following prior lumbar intervertebral disk operations].
20 patients with recurrent symptoms following operations for disc prolapse and resistant to treatment were studied by CT, using plain and enhanced images. The results have been analysed. In 10 patients a recurrence of disc prolapse was diagnosed, and this was confirmed surgically in 8 cases. In 2 patients there was epidural scarring. The findings indicate that differential diagnosis between scarring and recurring prolapse can be accurately made by this technique.
Adult↗
The postsurgical lumbosacral spine. Magnetic resonance imaging evaluation following intervertebral disk surgery, surgical decompression, intervertebral bony fusion, and spinal instrumentation.
It should be clear to those who perform and interpret medical images of the spine following one or more forms of surgical therapy that the images are often difficult to interpret in part because of the superimposition of the original disease process, alteration engendered by the surgery, or a complication of the surgical procedure. Although long-term experience in this area is helpful in regard to improving interpretive skills, certain sequela can be predicted regardless of the interpreter's background. Once the normal or expected postsurgical findings are understood, the subtle and gross changes that depart from these observations can be analyzed better. The importance of a high level of competence in the domain of post-therapeutic neurodiagnostic imaging is in the knowledge that the patient returning for restudy may be acutely in distress or even in medical danger (e.g., postoperative spondylitis). In fact, the clinical presentation posttherapeutically may well be more severe or dire than was observed pretherapeutically. An indepth appreciation of the broad range of clinicoradiologic possibilities as presented [figure: see text] here should place the medical imaging physician in an excellent position to provide an experienced diagnostic evaluation in the patient presenting with recurrent or new signs and symptoms following any one of the spectrum of possible spinal surgical procedures.
Decompression, Surgical↗
Urodynamic study in the neurogenic bladder dysfunction caused by intervertebral disk hernia.
AIMS: To discuss the clinical significance of urodynamic studies in neurogenic bladder dysfunction caused by intervertebral disk hernia. METHODS: Thirty patients with neurogenic bladder dysfunction caused by intervertebral disk hernia were divided into three groups according to the category of detrusor muscle activity: neurogenic detrusor overactivity without detrusor sphincter dyssynergia (DSD), neurogenic detrusor overactivity with DSD, or detrusor underactivity. The patients were divided into three groups according to the condition of urinary retention and incontinence: urinary retention, urinary incontinence, or neither urinary retention nor urinary incontinence. Also they were divided into three groups according to the location of the intervertebral disk hernia: cervical hernia, thoracic hernia, or lumbar hernia. All patients underwent computer tomography (CT), magnetic resonance imaging (MRI), and urodynamic study. The results were analyzed statistically. RESULTS: There was significant correlation between the category of detrusor muscle activity, bladder compliance (BC, P < 0.05), and the pressure at maximum flow (P(det,Qmax), P < 0.01). There were significant differences in post void residual (PVR), cystometric capacity (CC), and maximum flow rate (Qmax) between the three groups of urinary retention, urinary incontinence, and the group of neither retention nor incontinence (P < 0.05). There was statistical correlation between the location of the intervertebral disk hernia and the urodynamic results. There was significant correlation between the BC (the threshold was 15 ml/cmH(2)O), detrusor pressure (Pdet, the threshold was 40 cmH(2)O), DSD, the location of intervertebral disk hernia, and the upper urinary tract lesion (P < 0.01). CONCLUSIONS: Urodynamic studies are indispensable in the classification, diagnosis, treatment, and prognosis of the neurogenic bladder dysfunction caused by intervertebral disk hernia.
Adult↗