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Test Paper 2
Published in Teck Yew Chin, Susan Cheng Shelmerdine, Akash Ganguly, Chinedum Anosike, Get Through, 2017
Teck Yew Chin, Susan Cheng Shelmerdine, Akash Ganguly, Chinedum Anosike
A 36-year-old male patient with acute exacerbation of low back pain shows an 8 × 5 mm intermediate signal fragment lying in the epidural space with signal characteristics closely matching the lower lumbar discs. However, no definite continuity can be established with any of the local discs. Inflammatory markers and white cell count are normal. The most likely cause for this appearance would be Disc extrusionDisc protrusionMeningiomaSchmorl nodeSequestrated disc
The back
Published in Ashley W. Blom, David Warwick, Michael R. Whitehouse, Apley and Solomon’s System of Orthopaedics and Trauma, 2017
The ligamentum flavum is removed on the relevant side, if necessary, with some margin of the bordering laminae and medial third of the facet joint. The dura and nerve root are retracted towards the midline and the disc bulge or extrusion/sequestration is displayed. With an intact annulus an annulotomy is performed and the disc material removed. A far lateral disc protrusion cannot be visualized through the interlaminar approach and usually needs an extraforaminal approach.
Chapter Twelve
Published in Eugene Fukumoto, Advanced ICD-10 for Physicians Including Worker’s Compensation and Personal Injury, 2017
The MRI studies showed lumbar spine multilevel disc bulges. The narrative specifies:Posterior disc protrusion at L1-L2, 2 mm.Posterior disc protrusion at L2-L3, 4 mm.Posterior disc protrusion at L3-L4, 3 mm.Posterior disc protrusion at L4-L5, 4–5 mm, as well as lateral stenosis bilaterally.Posterior disc protrusion at L5-S1, 4–5 mm disc protrusion. The findings are consistent with annular tear.
Associations between lower back pain and job types in South Korean male firefighters
Published in International Journal of Occupational Safety and Ergonomics, 2021
MRI has opened up new possibilities for refined diagnostic classification of mechanical LBP in epidemiological research. Various abnormalities can be identified on spinal MRI, including disc herniation and nerve root impingement [28]. Endean et al. [28] reported that disc protrusion is the MRI abnormality most strongly associated with LBP, followed by disc degeneration, high-intensity zone/annular tear and nerve root displacement or compression (canal stenosis). However, even disc protrusion did not help to predict the occurrence of back pain [28]. While the prevalence of LBP in firefighters was associated with more than disc protrusion, it was associated with central canal stenosis in controls. Lumbar disc herniation, where the most common site is toward the bottom of the spine at L4–L5 or L5–S1, makes up the vast majority of spinal disc herniation cases (95%) [29]. Foraminal stenosis more frequently involves the L5 nerve root, as the L5–S1 foramen has a smaller foramen/root area ratio [29]. Considering the low LBP prediction rate of MRI findings, it is difficult to explain the difference in MRI findings significant for LBP in the firefighters and controls. However, we suggest that the MRI findings may be meaningful to compensate for the effect of spine abnormalities.
In Vitro Biomechanical Study of Epidural Pressure during the Z-shape Elevating-Pulling Reduction Technique for Cervical Unilateral Locked Facets
Published in Journal of Investigative Surgery, 2019
Xinwei Shao, Jican Zeng, Yuchun Chen, Lixian Wu, Xinjia Wang
Timely proper reduction of the locked facets preoperatively is essential to simplify the operation and improve the operative safety. The safety of the reduction of cervical unilateral locked facets is one of the key concerns among spine surgeons. The rupture of a disc could also cause posterior disc protrusion, displacing the spinal cord and resulting in cord compression; Eismont et al.16 reported a case in which a patient suffered severe nervous damage after closed reduction. Ordonez et al.17 believed that the closed reduction of cervical unilateral locked facets by spine traction leads to projection of the posterior fragments of the nucleus pulposus further into the spinal canal and aggravates the spinal cord compression. In contrast, Grant et al.18 and Lee et al.19 consider that spine traction could partially decrease the disc herniation, rather than increasing the disc herniation and leading to a deterioration of neurological function. The present results demonstrated that the halo vest-assisted Z-shape elevating-pulling reduction technique could rectify rotatory dislocation of the vertebral body, restore spinal canal volume and dynamic balance of the cervical spine, and achieve spinal decompression compared with the epidural pressure in the position of unilateral locked facets without aggravating the neurologic deterioration.
Recommended maximum holding time of common static sitting postures of office workers
Published in International Journal of Occupational Safety and Ergonomics, 2023
Somayeh Tahernejad, Mohsen Razeghi, Mohammad Abdoli-Eramaki, Hossein Parsaei, Mozhgan Seif, Alireza Choobineh
Consequently, a sitting posture that maintains the natural curvature of the spine allows the faster perception of muscle discomfort and pain due to the increased activity of the spinal muscles. However, injuries such as disc protrusion or damage to ligaments and ligamentous tissues may occur years after [34]. Therefore, in this study, which considered discomfort experiments as criteria for determining the recommended holding times of sitting postures, maintaining the natural curvature of the spine was resulted in higher discomfort in the subjects and the recommended holding time for this posture was less than that for the slumped posture.