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Damage to intervertebral discs
Published in Richard Graveling, Ergonomics and Musculoskeletal Disorders (MSDs) in the Workplace, 2018
Degenerated discs often (but not always) become painful, as nerves grow into them and become ‘sensitised’, usually as a result of inflammation or infection. Herniated discs can also cause ‘sciatica’—pain and numbness radiating to the buttocks or legs.
Spine
Published in David A Lisle, Imaging for Students, 2012
Sciatica refers to pain confined to a nerve root distribution, with leg pain being more severe than back pain. Sciatica may be accompanied by other neurological symptoms such as paraesthesia, and by signs of nerve root irritation such as positive straight leg raise test. Sciatica or leg pain syndromes are classified based on whether the pain is acute or chronic, unilateral or bilateral:Unilateral acute nerve root compression: ‘classical’ sciaticaUsually caused by focal disc herniationBilateral acute nerve root compression: cauda equina syndromeCauda equina syndrome refers to the sudden onset of bilateral leg pain accompanied by bladder and/or bowel dysfunctionUsually caused by a massive disc herniation or sequestrationUnilateral chronic nerve root compression: sciatica lasting for monthsUnilateral chronic sciatica may be caused by disc herniation or spinal stenosisBilateral chronic nerve root compressionBilateral chronic nerve root compression refers to vague bilateral leg pain aggravated by walking and slowly relieved by restUsually caused by spinal canal stenosisA common clinical difficulty is differentiating neural compression from vascular claudication– Clinical pointers that indicate a vascular cause include absent peripheral pulses, pain is in the exercised muscles, and rapid pain relief with rest.
Predictive factors for return to work after lumbar discectomy
Published in International Journal of Occupational Safety and Ergonomics, 2021
Maryam Atarod, Elham Mirzamohammadi, Hasan Ghandehari, Ramin Mehrdad, Nazanin Izadi
Lower back pain (LBP) is one of the most common complaints leading to disability and work absence. Only a few cases of LBP are pathological with exclusive etiologies. Sciatic pain is a radicular pain radiating to the legs and feet with motor and sensory symptoms [1]. Totally, a prolapsed disc is responsible for 20% of cases with LBP [2]. Approximately 5–10% of patients with LBP have sciatica, whereas LBP has a prevalence of 49–70% [3]. In epidemiological studies, different contributing factors such as personal, occupational and lifestyle factors were related to LBP. Non-vocational factors such as age, gender, smoking, physical fitness and congenital structural disorders, such as spondylolisthesis, and occupational factors including heavy lifting, awkward postures, pulling and pushing are some risk factors for LBP [4,5].
Expert review with meta-analysis of randomized and nonrandomized controlled studies of Barricaid annular closure in patients at high risk for lumbar disc reherniation
Published in Expert Review of Medical Devices, 2020
Larry E. Miller, R. Todd Allen, Brad Duhon, Kris E. Radcliff
Sciatica affects 10% of adults in the United States each year [1] and is a leading cause of disability [2]. Affected individuals experience severe radiating pain along the distribution of the sciatic nerve through the buttocks and leg. Herniation of the nucleus pulposus from within the lumbar intervertebral disc space to the extradiscal space is the primary instigating event in sciatica. Extrusion or sequestration of disc contents may cause these radicular symptoms by direct impingement of adjacent nerve roots or induction of local inflammatory processes. The prognosis of individuals with sciatica is generally favorable with approximately two-thirds of patients reporting complete symptom resolution after 1 year [3,4]. However, bothersome symptoms that are refractory to conservative treatments persist in the remaining one-third of patients who are often referred for lumbar disc surgery to remove the offending herniated disc contents. While continued conservative treatment may also be considered, increasing evidence suggests that surgery is more effective than continued conservative care for chronic sciatica symptoms [5].
STUDY PROTOCOL – pulsed radiofrequency in addition to transforaminal epidural steroid injection in patients with acute and subacute sciatica due to lumbosacral disc herniation: rationale and design of a phase III, multicenter, randomized, controlled trial
Published in Expert Review of Medical Devices, 2020
Roberto Scipione, Giulia Alfieri, Alessandro De Maio, Emanuela Panella, Simone Napoli, Luca Bianchi, Nunziante Pandaloro, Alberto Bazzocchi, Giancarlo Facchini, Ugo Albisinni, Paolo Spinnato, Carlo Catalano, Alessandro Napoli
In patients with sciatica, the most common complaints are pain and disability to perform normal daily activities. We will use the parameters described below, which will be assessed by self-reported questionnaires. Patients will not be informed about their earlier scores. Primary outcomes will be evaluated at 1, 4, 12, and 52 weeks; secondary outcomes will be evaluated at 4, 12, and 52 weeks.