1/6. Myxomatous degeneration of the ligamentum flavum of the lumbar spine.STUDY DESIGN: Report of two cases of acute lumbar nerve root compression caused by myxomatous degeneration of the ligamentum flavum. OBJECTIVE: To report a rare cause of acute lumbar nerve root compression. SETTING: Orthopaedic department, Osaka, japan. SUMMARY OF BACKGROUND DATA: Two patients, both 50-year-old men presenting with signs and symptoms suggestive of acute lumbar nerve root compression were found to have a ligamentum flavum mass. The masses were removed and the patients regained normal function postoperatively. methods: To reveal the nature of the mass, histopathological studies were made. Continuous sections were prepared from the removed mass lesions. The sections were stained with hematoxylin and eosin, van Gieson's stain, azan stain, periodic acid Schiff reaction, alcian blue stain and von Kossa's stain. RESULTS: Histological examination revealed myxomatous degeneration of the ligamentum flavum. No elastic fibers were found at the degeneration site. Diffuse mucopolysaccharide deposition was found at the degeneration site, however, no cyst was found. collagen fibers were not increased. hypertrophy or ossification of the ligamentum flavum was not recognized in the sections. At a follow-up examination over 2 years later, the patients were free of symptoms and the findings of a neurological examination were normal. CONCLUSION: Two cases of myxomatous degeneration of the ligamentum flavum of the lumbar spine were reported, which have seldom been described as the cause of acute lumbar nerve root compression.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
2/6. Cyclic sciatica related to an extrapelvic endometriosis of the sciatic nerve: new concepts in surgical therapy.Sciatic pain caused by endometriosis of the sciatic nerve is an uncommon clinical finding and seems to have been verified histologically in only a few cases. patients complain of typical signs and symptoms of common sciatica that are cyclic in nature. Suggested compression of lumbar root or sciatic nerve or its plexus could be confirmed by electromyography, computed tomography, or magnetic resonance imaging, and by prompt response to hormonal suppression of ovarian function with regression of the radiologic findings. patients often have required radical surgery with total hysterectomy and bilateral salpingo-oophorectomy. However, conservative surgery with excision of the endometriosis from the nerve can be successful in selected patients who wish to preserve reproductive function. We report a case of sciatic nerve involvement explored by magnetic resonance imaging, with endometriosis in contact with the nerve in the right sciatic trunk.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
3/6. herpes zoster: a consideration in the differential diagnosis of radiculopathy.herpes zoster probably occurs more often than generally thought. Since it produces a radicular distribution of pain, it should be included in the differential diagnosis of radiculopathy. A case is presented in which evaluating the radicular low back pain before the characteristic rash appears was misleading. Careful history-taking concerning the exact nature of the pain and sensory changes is needed to differentiate between zoster and radiculopathy, if no rash is evident.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
4/6. endometriosis of the sciatic nerve: a report of two cases and a review of the literature.endometriosis of the sciatic nerve is rare but must be included in the differential diagnosis of sciatic pain. patients present with typical signs and symptoms of sciatica, which are cyclic in nature. electromyography and computed tomographic scanning are useful in diagnosis. At laparoscopy or laparotomy, a characteristic "pocket sign" is frequently seen, and may be the only clue to the presence of endometriosis. The patient often requires definitive surgery with total abdominal hysterectomy and bilateral salpingo-oophorectomy. However, conservative surgery with excision of the endometriosis from the nerve can be successful in selected patients who wish to preserve reproductive function.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
5/6. role of computed tomography in patients with "sciatica".The computed tomography (CT) findings in 10 patients who presented with lumbosacral radicular symptoms are reported. The CT scans were performed after the more commonly used radiologic studies, including plain films and myelography, had failed to completely define the nature or extent of the underlying disease process. The final diagnoses were metastatic neoplasm to the spine and soft tissue in six cases, primary neoplasm of the sacrum or soft tissue in three cases, and tuberculous osteomyelitis and abscess in one case. The limitations and potential complications of the various radiologic examinations are discussed, and the potential value of CT in selected patients with lumbosacral neuropathy is presented.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
6/6. Autoamputation of the first sacral nerve roots in spondyloptosis.To our knowledge, this is the first reported case of bilateral autoamputation of the first sacral nerve roots in a patient who has spondyloptosis. The authors think that autoamputation occurred in adolescence during a period of rapid forward displacement of the fifth lumbar vertebra on the sacrum. It is postulated that the lack of motor weakness is due to the long-standing nature of the denervation and that other adjacent nerve roots supplying the triceps surae have, over time, increased the power of those muscle fibers not supplied by the first sacral roots. This finding would encourage development of methods for early reduction and fusion in children showing marked restriction of straight leg raising (ie, tight hamstrings) to prevent rapid listhesis and fixation of the fifth lumbar vertebra to the sacrum.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |