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Computer-Aided Diagnosis of Spinal Abnormalities
Published in de Azevedo-Marques Paulo Mazzoncini, Mencattini Arianna, Salmeri Marcello, Rangayyan Rangaraj M., Medical Image Analysis and Informatics: Computer-Aided Diagnosis and Therapy, 2018
Marcello H. Nogueira-Barbosa, Paulo Mazzoncini de Azevedo-Marques
The most common intervertebral disc disease is degeneration, although less frequently infection, inflammatory diseases, or even more rarely, neoplasm may affect disc tissue. Intervertebral disc degeneration usually occurs with loss of glycosaminoglycans and water content, with concomitant increase in type I collagen. Such biochemical compositional changes lead to structural failure. Annulus fibrosus fibers may tear and subsequently nucleus pulposus material may be displac ed to peripheral regions of the disc. Focal disc material displacement beyond the limits of the intervertebral disc space delimited by the vertebral bodies gives rise to intervertebral disc herniation. Intervertebral disc herniation may cause or may contribute to spinal cord or nerve root compression when the disc displacement occurs toward neural tissue. Intervertebral disc displacement may contribute to spinal canal obliteration, a situation that may characterize spinal canal stenosis. Spinal cord and nerve root compression symptoms vary according to the compressed structure and depending on the level of compression. Intervertebral disc degeneration alone, without disc herniation or nerve compression, may cause localized back pain. Nerve root compression secondary to abnormal disc morphology is usually accompanied by pain radiating to the upper or the lower limb, respectively, in the case of nerve compression in the cervical or lumbar regions.
Spine
Published in David A Lisle, Imaging for Students, 2012
Nerve root compression produces local neck pain plus pain in the distribution of the compressed nerve. Osteoarthritis uncomplicated by compression of neural structures may cause episodic neck pain with the following features:Tends to be increased by activityMay be associated with shoulder pain or headacheUsually resolves within 7–10 days.
Use of lasers in minimally invasive spine surgery
Published in Expert Review of Medical Devices, 2018
The procedure is performed in two stages: (1) a standard posterior cervical approach to expose the index foraminal area; (2) laser-assisted selective discectomy and foraminotomy using microscopic CO2 laser. Under general anesthesia, the patient is positioned in prone position on a radiolucent operation table. After a small skin incision is made, subperiosteal dissection is performed along the surface of the laminoforaminal area. Then, a self-retractor or tubular retractor is applied, which exposes the surgical field centered on the laminofacet junction point (Figure 2(a)). Minimally invasive foraminotomy is then performed, centering the point using high-speed drill. After exposing the compressed nerve root and disc space, the engorged veins overlying the nerve root are coagulated and removed. Once the compressed nerve root is identified, the extruded disc fragments and osteophytes are removed using CO2 laser with gentle nerve root protection (Figure 2(b)). The direction of the laser beam can be controlled using a joystick attached to the microscope. The unit can be activated for laser emission by a footswitch. A pinpoint-size laser is usually used at a power level of 10 W, which allows safe and precise ablation. CO2 laser is also used to dissect adhesions and evaporate any hypertrophic bone or osteophyte (Figure 2(c)). The photocoagulation effect of the laser may reduce bleeding during the decompression process. Once the nerve root is completely decompressed and freely mobilized, the surgical procedure can be finished.
Biomechanical evaluation of Percutaneous endoscopic posterior lumbar interbody fusion and minimally invasive transforaminal lumbar interbody fusion: a biomechanical analysis
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2023
Jia-Rui Li, Yang Yan, Xiao-Gang Wu, Li-Ming He, Hao-Yu Feng
Lumbar disc herniation is one of the most common lumbar diseases. It causes back pain, lower limb radiating pain and other symptoms (Kim et al. 2018), affecting the daily work and life of patients. Conservative treatment cannot relieve the pain caused by nerve root compression, and long-term dural sac compression may cause serious complications (Ko 2018), so severe lumbar disc herniation requires surgical treatment (Liu and Zhou 2019).
Pulsed radiofrequency for low-back pain and sciatica
Published in Expert Review of Medical Devices, 2020
Alessandro Napoli, Giulia Alfieri, Roberto Scipione, Fabrizio Andrani, Andrea Leonardi, Carlo Catalano
About 90% of patients with low-back pain will have symptoms without a clear-specific cause. The presence of nerve root problems is an indicator of possible underlying pathology [2]: the most common cause of lumbar radicular pain is intervertebral disc herniation (DH), followed by failed back surgery (FBSS) and spinal stenosis (SS) [3].