Other Disorders of the Spine

Curlee, Patrick M.

doi:10.1016/b978-0-323-03329-9.50044-1

Cited by 7 publications

(19 citation statements)

References 698 publications

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“…Use of epidural steroid injection for the treatment was first reported in 1953 9 . Steroids reduce inflammation 10,11 by inhibiting proinflammatory mediators like phospholipase A2, histamine etc and by the action of stabilizing hyper-excitable nerve membranes. In addition to being a less invasive procedure, epidural steroid injections have less morbidity and mortality compared to the surgical procedures 12 .…”

Section: Introductionmentioning

confidence: 99%

Epidural Steroid Injection in the Management of Patients with Subacute or Chronic Low Back Ache with Radiculopathy due to Herniated Disc

Gul¹,

Kirmani²,

Bhat³

et al. 2018

IJCMR

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Introduction: Low back ache is the most common problem seen in orthopedic clinic. Low backache with lumbosacral radiculopathy remains the most challenging musculoskeletal problem for its therapeutic management. In around 90% patients, the cause of low back with radiculopathy is a prolapsed disc. Epidural steroid injections are used in the management of patients with subacute or chronic low backache with radiculopathy, not responding to conservative treatment. The aim of study was to check the efficacy of epidural steroid injection in patients of subacute or chronic low backache with radiculopathy due to herniated disc. Material and Methods: The study was conducted over 100 patients reporting to our OPD with chief complaints of LBA with radiculopathy, not responding to conservative treatment. Maximum of three epidural steroid injections were given with two weeks of interval in between. The patients were assessed before and after the procedure and assessment was done using VAS scoring system. Results: In our study, 80% patients got a significant improvement in symptoms according to VAS scoring system. Out of them, 70% improved with only a single dose of ESI, 20% with the second dose and the remaining 10% after third dose. Also the procedure was found to be more effective in treating patients of subacute low backache with radiculopathy rather than the chronic one. Conclusion: ESI is a safe, cost effective and minimally invasive method of treating patients of subacute or chronic LBA with radiculopathy due to herniated disc. The procedure decreases analgesic use and allows early return to work.

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Section: Introductionmentioning

confidence: 99%

Epidural Steroid Injection in the Management of Patients with Subacute or Chronic Low Back Ache with Radiculopathy due to Herniated Disc

Gul¹,

Kirmani²,

Bhat³

et al. 2018

IJCMR

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“…In general, the symptoms start slowly and gradually. However, they may be exacerbated through trauma and intense activity (4) .…”

Section: Introductionmentioning

confidence: 99%

“…Central stenosis results from a decrease in the canal diameter anteroposteriorly, transversally or a combination of these, secondarily to loss of disc height, annulus lesion and osteophyte formation, thus leading to instability that gives rise to hypertrophy of the facets and the yellow ligament (3) . Degeneration of the intervertebral discs causes decreased relative stability and for this reason, facet hypermobility occurs (4) . A study on cadavers suggested that pressure on the facets increases with decreasing disc height and with extension of the spine (7) .…”

Section: Introductionmentioning

confidence: 99%

Degenerative Stenosis of the Lumbar Spine

Zylbersztejn

Spinelli

Rodrigues³

et al. 2012

Revista Brasileira de Ortopedia (English Edition)

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This paper presents an update on degenerative stenosis of the lumbar spine, which is a common pathological condition among patients over the age of 65 years. The anamnesis and physical examination need to be precise, since radiography often only provides indirect signs. Magnetic resonance imaging is necessary if the symptoms persist. The treatment for lumbar stenosis is a matter of controversy. However, there seems to be some benefit from surgical treatment rather than conservative treatment, such that surgery brings improvements in symptoms and functions for a period of up to two years.

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“…Degeneration of the intervertebral discs causes decreased relative stability and for this reason, facet hypermobility occurs [5]. A study on cadavers suggested that pressure on the facets increases with decreasing disc height and with extension of the spine [6].…”

Section: Discussionmentioning

confidence: 99%

Clinical profile of degenerative lumbar spinal canal stenosis and its outcome after surgical management

Krishna

khar

et al. 2019

Int J Surg Ortho

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Introduction: Degenerative spinal stenosis is a progressive disorder that involves the entire spinal motion segment as described by Kirkaldy-Willis. With this a study was conducted to assess the degenerative lumbar spinal canal stenosis which is managed by laminectomy, decompression and to assess the results of decompression. Materials and Methods: Study was conducted in the department of orthopedics, GSL Medical College. Patients having low back pain and radiating pain to lower limbs. After preparation of surgical area thorough scrubbing, painting and draping was done. To improve hemostasis through local anesthesia 0.5% xylocaine with epinephrine was injected in operative area. Skin was incised thorough midline incision. Electrocautery was used to dissect down to the level of spinous process. Self retaining retractor was then placed within the wound. Once the levels were identified ankobbsis was used to retract the para-spinous muscular attachments to the bone. P< 0.05 was considered statistically significant. Results: Total 50 patients were included in this study. When post operative walking distance was considered, 10% patients were able to walk < 50 feet, 56% walked 50 feet to 2 block and 34% could walk 2 blocks to 2 miles. Excellent SSSS end results were observed in 78% participants, 16% reported good results and poor results in 8% cases. Conclusion: Surgical decompression of laminectomy gives good outcome in degenerative lumbar spinal stenosis and there was excellent improvement of patients after surgery.

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Other Disorders of the Spine

Cited by 7 publications

References 698 publications

Epidural Steroid Injection in the Management of Patients with Subacute or Chronic Low Back Ache with Radiculopathy due to Herniated Disc

Epidural Steroid Injection in the Management of Patients with Subacute or Chronic Low Back Ache with Radiculopathy due to Herniated Disc

Degenerative Stenosis of the Lumbar Spine

Clinical profile of degenerative lumbar spinal canal stenosis and its outcome after surgical management

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