Articles: low-back-pain.
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Diagnosis of lumbar facet joint disease is the sum of the combinations consisting of history, physical activity, and diagnostic imaging frequently including computed tomography and magnetic resonance imaging scans. Prevalence of facet-based chronic low back pain is 15-45%. Intra-articular injections with corticosteroid or medial branch block are traditionally used prevalently in the management of chronic low back pain due to lumbar facet joints. However, the evidence levels of these procedures are at either a low or a medium level. Radiofrequency neurolysis of the lumbar medial branch can be used as an alternative in the management of lumbar facet joint pain. There are two types of radiofrequency applications for radiofrequency neurolysis as pulsed radiofrequency and conventional radiofrequency. ⋯ Conventional radiofrequency in patients with lumbar facet joint pain for medial branch neurolysis effectively decreases Visual Analogue Scale values in both short and long term. The quality of life and daily activities of patients were better at conventional radiofrequency.
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To determine the efficacy of discography and discoblock in the treatment of low back pain (LBP) associated with painful Schmorl's nodes (SNs). ⋯ Painful SNs refractory to medical or physical therapy should be an indication for treatment with discography and discoblock.
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J Neurol Surg A Cent Eur Neurosurg · Jan 2018
Case ReportsCombination of Transforaminal and Interlaminar Percutaneous Endoscopic Lumbar Diskectomy for Extensive Down-migrated Disk Herniation.
The technique and instrumentation of percutaneous endoscopic lumbar diskectomy (PELD) have significantly improved. Thus its indications have been gradually expanding. Down-migrated disk, in particular, is regarded inaccessible by rigid instrumentation due to poor visualization and limited accessibility. We introduce a combination of transforaminal and interlaminar PELD for extensive down-migrated disk herniation at the L4-L5 level. ⋯ It is difficult to remove entire disk fragments using only a transforaminal or interlaminar approach for extensive down-migrated disk herniation. Therefore a combination of transforaminal and interlaminar PELD may be effective for extensive down-migrated disk herniation at L4-L5.
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Varicella zoster virus remains dormant in the dorsal root ganglia after childhood exposure to chickenpox. Its reactivation results in herpes zoster, otherwise known as shingles, which is a painful vesicular rash in a dermatomal distribution. We present a case of foraminal disk extrusion that resulted in radicular pain in a dermatomal distribution. The resultant inflammatory response around the dorsal root ganglion triggered an episode of shingles, which elegantly highlights the pathophysiology of this condition at a gross anatomic level.