scholarly journals Conservative and non-surgical management of lumbar disc herniation

2020 ◽  
Vol 1 (2) ◽  
pp. 15
Author(s):  
Kashinath G Metri ◽  
Seema Rathi ◽  
Jalandhara   ◽  
Amit Singh ◽  
Nagaratna R.
Keyword(s):  
Lumbar Disc ◽  
Normal Function ◽  
Foot Drop ◽  
Yoga Intervention ◽  
Classical Sign ◽  
Breathing Techniques ◽  
Yogic Breathing ◽  
Discal Herniation ◽  
One Year ◽  
Guided Relaxation

A case of a 16-year-old Indian adolescent with discal herniation in L4 – L5 region with classical sign of ‘foot drop’ was successfully managed by conservative, non-surgical approach following principles of yoga intervention. Patients practised yoga under supervision of yoga expert, four times a day for first two weeks followed by once a day for consecutive two years. Yoga protocol included gentle yoga based loosening practices, simple asanas, yogic breathing techniques and yogic guided relaxation, pranayama and meditation. One year and two-year follow-ups showed complete revival of normal function and healing of the affected spinal cord disorder. A case which was recommended for surgery recovered with yoga intervention.

scholarly journals Compressive Lumbar Disc Hernia Spontaneously Disapeared in a Few Years - Case Report

2016 ◽  
Vol 22 (4) ◽  
pp. 256-259
Author(s):  
D. Balasa ◽  
Carmen Ciufu ◽  
R. Baz ◽  
Anca Hancu
Keyword(s):  
Magnetic Resonance Imaging ◽  
Case Report ◽  
Magnetic Resonance ◽  
Conservative Treatment ◽  
Lumbar Disc ◽  
Resonance Imaging ◽  
Disc Hernia ◽  
Small Intensity ◽  
Lumbar Disc Hernia ◽  
One Year

Abstract We present a patient with left compressive L5-S1 lumbar disc hernia in lateral reces and foramina revealed by high intensity pain (Visual Autologus Scale 7/10) and paresthesias on the left S1 dermatoma for 5 months. He refused surgery and followed conservative treatment with very good results after 6 months. The radicular S1 pain became of a small intensity (Visual Autologus Scale 2-3/10) and intermitent and after one year it completely disapeared. After 4 years he repeated the lumbar magnetic resonance imaging which proved the disapearance of the L5-S1 lumbar disc hernia.

scholarly journals One-year outcomes of early-crossover patients in a cohort receiving nonoperative care for lumbar disc herniation

2017 ◽  
Vol 27 (4) ◽  
pp. 391-396 ◽  
Author(s):  
Anurekha Ramakrishnan ◽  
K. Michael Webb ◽  
Matthew C. Cowperthwaite
Keyword(s):  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Regression Models ◽  
Lumbar Disc ◽  
Recursive Partitioning ◽  
Chi Square ◽  
Logistic Regression Models ◽  
Spine Intervention ◽  
Euroqol 5D ◽  
One Year

OBJECTIVEThe authors comprehensively studied the recovery course and 1-year outcomes of early-crossover patients who were randomized to the nonoperative care arm of the Leiden–The Hague Spine Intervention Prognostic Study. The primary goal was to gain insight into the differences in the recovery patterns of early-crossover patients and those treated nonoperatively; secondary goals were to identify predictors of good 1-year outcomes, and to understand when and why patients were likely to cross over.METHODSIndividual EuroQol-5D scores were obtained at baseline and at 2, 4, 8, 12, 26, 38, and 52 weeks for 142 patients. Early-crossover patients were defined as those electing to undergo surgery during the first 12 weeks of treatment. Crossover and noncrossover groups were compared using Kruskal-Wallis, Wilcoxon-Mann-Whitney, and chi-square tests. Linear mixed-effects models were used to examine the growth trajectories of crossover and noncrossover groups. Recursive partitioning trees were used to model crossover events and the timing of crossover decisions. Multivariable logistic regression models were used to identify predictors of good 1-year outcomes.RESULTSOf the 142 patients randomized to receive prolonged nonoperative care, 136 were selected for the study. In this cohort, 43/136 (32%) opted for surgery, and 31/43 (72%) of crossover events occurred before the 12-week time point. Early-crossover patients had significantly greater functional impairment at Week 2 than noncrossover patients (p = 0.031), but experienced greater recovery by 26 weeks and better 1-year outcomes (p = 0.045). Patients who did not experience an improvement in their symptoms between 2 and 8 weeks were more likely to cross over (OR 3.5, 95% CI 1.2–10.1; p = 0.01). Recursive partitioning trees were able to identify crossover patients with 76% accuracy. Regression models suggested that better recovery at 26 weeks (p < 0.01) was predictive of good 1-year outcome; declining health status between Weeks 4 and 8 was negatively predictive of good outcome (p < 0.01).CONCLUSIONSThis study is the first to comprehensively analyze the recovery and outcomes of crossover patients, and compare them to nonoperatively treated patients. The results suggest that patients who have a low EuroQol-5D score during the early weeks of treatment and who do not respond to nonoperative care during the first few weeks of treatment are most likely to cross over. Early-crossover patients experience a greater rate of recovery and more frequently have a good 1-year outcome when compared with nonoperatively treated patients. The current results motivate a broader investigation into the timing of surgery and the identification of patient populations that will be most benefited by early surgical treatment for lumbar disc herniation.

scholarly journals Cauda Equina Syndrome after Sequestered Disc Herniation Migrating to the Dorsal Epidural Space: Case Report and Review of the Literature

2020 ◽  
pp. 1-2
Author(s):  
Abdullah Alshammari ◽  
Abdullah Alshammari ◽  
Michael Weber ◽  
Rodrigo Navarro-Ramirez ◽  
Susan Ge
Keyword(s):  
Epidural Space ◽  
Cauda Equina Syndrome ◽  
Lumbar Disc ◽  
Cauda Equina ◽  
Foot Drop ◽  
Low Back ◽  
Decompressive Laminectomy ◽  
Safe Management ◽  
Disc Herniations ◽  
Space Case

Background: Posteriorly migrated epidural disc fragments (PMEDF) presenting with cauda equina syndrome are relatively common. These cases are sometimes inaccurately identified on MRI as; epidural tumors, abscesses, hematomas and or facet cysts. Proper description and identification are key to be able to provide effective and safe management. Currently we are presenting the case of a patient with cauda equina syndrome secondary to a posterior mass compression intraoperatively identified as a PMEDF. Case Description: 45-years-old male presenting with insidious low back pain that progressed to urinary retention and bilateral foot drop. An MRI of the lumbar spine showed a posteriorly located epidural lesion. That appeared to be dependent on a left facet cyst. The patient was treated with a decompressive laminectomy and multiple disc fragments were identified under the ligamentum flavum and over the posterior epidural space. Conclusion: Posterior epidural migration of a lumbar disc fragments (PEMLDF) are not a common presentation of intervertebral disc herniations and their differential diagnosis and treatment might require a different surgical approach; fusion vs decompression. PEMLDFs should be suspected on those patients presenting with sudden cauda equina syndrome and posteriorly located epidural lesions on MRI.

scholarly journals Prognosis for Recovery of Foot Drop after Transforaminal Endoscopic Decompression of Far Lateral Lumbar 5-Sacral 1 Herniated Disc: Case Series

2019 ◽  
Vol 2 (22.2) ◽  
pp. E97-E103
Author(s):  
Albert Telfeian
Keyword(s):  
Endoscopic Treatment ◽  
Case Series ◽  
Foot Drop ◽  
Consecutive Series ◽  
Motor Score ◽  
Endoscopic Decompression ◽  
Far Lateral ◽  
The Mean ◽  
One Year

Background: Foot drop that results from compression of the exiting L5 nerve as a result of far lateral disc herniation (FLDH) at L5-S1 poses a significant surgical challenge to the minimallyinvasive spine surgeon given the narrow corridor for an extraforaminal approach because of the high iliac crest. Objectives: Here we describe our experience with transforaminal endoscopic decompression for the treatment of foot drop secondary to FLDH at L5-S1. Study Design: Retrospective case review. Setting: This study took place in a single-center, academic hospital. Methods: A technique for the transforaminal endoscopic treatment of foot drop secondary to L5-S1 FLDH is presented in a series of 5 consecutive patients treated over a period of 3 years. Preoperative and postoperative clinical data with 1-year follow-up are presented. Results: A consecutive series of 211 patients who underwent transforaminal endoscopic treatment for lumbar radiculopathy between 2011 and 2014 are presented. Seventy-seven patients had L5- S1 discectomies and 5 of those patients presented with foot drop and FLDH. The mean visual analog scale score for radicular pain improved from an average pain score before surgery of 7.2 to 0.8 one year after surgery, and the mean motor score for anterior tibialis strength improved from an average motor score before surgery of 2.6 to 4.8 one year after surgery. Limitations: Small case series evaluated retrospectively with one year follow-up. Conclusions: Transforaminal endoscopic surgical access to FLDH pathology may be a unique approach to the treatment of foot drop because it allows for neural decompression of disc and foraminal pathology without requiring significant destabilizing bone removal. Key words: E

scholarly journals Outcome of Surgical Treatment for Lumber Disc Herniation Causing Painful Incomplete Foot-Drop

2020 ◽  
Vol 24 (3) ◽  
Author(s):  
MUSAWER KHAN ◽  
AKRAM ULLAH ◽  
ADNAN AHMED ◽  
MUMTAZ ALI ◽  
MANSOOR AHMAD
Keyword(s):  
Surgical Treatment ◽  
Pain Relief ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Cauda Equina ◽  
Foot Drop ◽  
Disc Disease ◽  
Lumbar Disc Disease ◽  
Number Of Patients

Objective:  To determine the outcome of surgical treatment for lumder disc herniation causing the painful incomplete foot drop. Material and Methods:  This retrospective observational study was conducted at the Department of Neurosurgery Lady Reading Hospital, Peshawar. Both Male and female patients with lumbar disc disease causing unilateral incomplete painful foot drop were included in our study. Patients with complete or painless foot drop, bilateral foot-drop, Multiple level disc prolapse, cauda equina syndrome or sciatic neuropathy due to injection injury were excluded. Patients were followed was post-operatively in terms of power in foot dorsiflexion, medical research council (MRC) grade and pain relief  on a Visual Analogue Scale (VAS) after 1 month and then after 6 months. Results: Total number of patients included were 43. Age was ranging from 18 years to 54 years and mean age was 33 years. Before surgery,  power of MRC grade 3 or less, but greater than 1 in dorsiflexion was noted in all patients. The pain was scaled using VAS. Post peratively, at 1 month follow up, the foot-drop improved to MRC grade 4 or 5 along with pain relief of ≥ 2 points on VAS in 81. 4% (n = 35) patients and at 6 month follow-up, the figure rose to 93% (n = 40). Conclusion:  Lumbar disc disease can cause a debilitating foot-drop and pain. Improving or restoring a neurology early surgical intervention has proven benefits.

scholarly journals Yogic Breathing and Mindfulness as Stress Coping Mediate Positive Health Outcomes of Yoga

Mindfulness ◽  
2019 ◽  
Vol 10 (12) ◽  
pp. 2703-2715 ◽  
Author(s):  
Una Tellhed ◽  
Daiva Daukantaitė ◽  
Rachel E. Maddux ◽  
Thomas Svensson ◽  
Olle Melander
Keyword(s):  
Psychological Health ◽  
Sleep Problems ◽  
Positive Impact ◽  
Control Group ◽  
Stress Coping ◽  
Positive Health ◽  
Yoga Intervention ◽  
Yogic Breathing ◽  
As Stress ◽  
Positive Health Outcomes

Abstract Objectives Despite accumulating research on yoga and its positive impact on both physiological and psychological health, it is still unclear how yoga improves health. Two central components of yoga, yogic breathing and mindfulness, may be important mechanisms by which individuals learn to cope with their daily stressors, and thereby reduce their risk of developing stress-related illness. In this study, we experimentally tested whether yogic breathing as a stress coping mechanism and increased mindfulness mediates the psychological health benefits of a yoga intervention Methods Seventy-one middle-aged adults (78% women; Mage 53.5 ± 6.9) who self-rated as moderately stressed were randomly assigned to either a control group or a 5-week yoga intervention called the Yoga and Mindfulness Intervention (YOMI) program. The YOMI combines 60 min of yin yoga practice with 30 min of psychoeducation, administered twice weekly; participants also completed a 5-min breathing exercise as homework daily. Results The YOMI group showed greater reductions in anxiety, depression, and sleep problems compared with controls (R2 varied between .09 to .23), and these reductions were statistically mediated by increased use of yogic breathing and a related increase in participants’ overall mindfulness. Conclusions These mediation results provide new insights into how yoga improves psychological health and suggests promising implications for policymakers aimed at improving public health.

Sign in / Sign up

Export Citation Format

Share Document