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Low Back Pain
Published in Benjamin Apichai, Chinese Medicine for Lower Body Pain, 2021
Lumbar spinal stenosis is the condition of a narrowing passageway within the spine whereby the nerve roots leaving the spinal column are compressed. It is another common cause of sciatica. Some people with spinal stenosis may not have symptoms.
Neurosurgery: Spine surgery
Published in Hemanshu Prabhakar, Charu Mahajan, Indu Kapoor, Essentials of Geriatric Neuroanesthesia, 2019
M.V.S. Satya Prakash, M. Senthilnathan
Degenerative diseases of spine can be divided in to four types: Degenerative disc disease: Occurs due to reduced water content, decrease in disc space, and alteration of the collagen content in the disc.Spondylolisthesis: Slipping or displacement of the one vertebra over another. It is common at L4/L5 (3).Prolapse of the disc: Leads to radicular pain of the nerve roots. This occurs due to the irritation and inflammation of the nerve root by the biologically active tissue within the disc, such as nucleus pulposus.Spinal stenosis: Due to narrowing of the spinal canal.
A Randomized, Controlled Trial of Fusion Surgery for Lumbar Spinal Stenosis *
Published in Alexander R. Vaccaro, Charles G. Fisher, Jefferson R. Wilson, 50 Landmark Papers, 2018
Jerry C. Ku, Jefferson R. Wilson
Lumbar spinal stenosis is the most common indication for spinal surgery, and studies have shown that surgical treatment in selected patients is more successful than conservative measures. The aim of this study was to investigate whether fusion surgery as an adjunct to decompression surgery resulted in better clinical outcomes than decompression alone in patients with lumbar spinal stenosis, with or without degenerative spondylolisthesis.
Kratom-induced common bile duct dilation
Published in Baylor University Medical Center Proceedings, 2023
Marjan Haider, Neil Shah, Ali Yazdani
A 57-year-old woman with a history of spinal stenosis presented to the hospital with acute on chronic back pain and vague symptoms of abdominal discomfort, decreased appetite, nausea, and constipation. She had no fevers or chills. She used as-needed ibuprofen for back pain but denied any opiate use. She reported using kratom, 10 g daily, over the last year. Her workup in the hospital revealed normal liver and renal chemistries. Computed tomography of the abdomen and pelvis revealed moderate extrahepatic biliary ductal dilation to 9 mm extending to the ampulla. An abdominal ultrasound showed common bile duct dilation to 13 mm. Intrahepatic biliary dilation was present as well. Magnetic resonance cholangiopancreatography (MRCP) revealed mild central intrahepatic and more pronounced extrahepatic bile duct dilatation, with the common bile duct measuring up to approximately 12 mm (Figure 1). No definite filling defects or evidence of stricture or choledocholithiasis was appreciated.
The impact of functional exercise on the reversal of acromegaly induced frailty: a case report
Published in Physiotherapy Theory and Practice, 2022
Colleen G. Hergott, Jessica Lovins
A 73-year-old male was admitted to a skilled nursing facility after (SNF) experiencing a significant functional decline following acoronary artery bypass graft (CABG) procedure with aortic valve replacement and subsequent multiple complications. At age 40, he had previously undergone excision of a pituitary tumor following a diagnosis of acromegaly. The patient’s past medical history (PMHx) included comorbidities consistent with acromegaly such as osteoarthritis in multiple joints, peripheral muscle weakness, peripheral neuropathy, atherosclerosis, and aortic valve stenosis. PMHx also included bilateral total hip arthroplasty and he was a candidate for a total knee arthroplasty. Severe right shoulder arthritis osteoarthritis and rotator cuff tear limited right shoulder flexion to 70 degrees. The patient reported chronic low back pain and limited trunk mobility from spinal stenosis. The prior level of function (PLOF) included independent ambulation of all community distances without an assistive device.
Association between spinal stenosis and wild-type ATTR amyloidosis
Published in Amyloid, 2021
Amandeep Godara, Ron I. Riesenburger, Diana X. Zhang, Cindy Varga, Teresa Fogaren, Nauman S. Siddiqui, Anthony Yu, Andy Wang, Michael Mastroianni, Richard Dowd, Tara J. Nail, Ellen D. McPhail, Paul J. Kurtin, Jason D. Theis, Denis Toskic, Knarik Arkun, Monika Pilichowska, James Kryzanski, Ayan R. Patel, Raymond Comenzo
ATTRwt has been found in the tendons, ligaments and joints of elderly patients but the significance of its presence is not well understood [8–12]. Spinal stenosis (SS) is also a degenerative condition that primarily affects people older than 60 years, and surgical management involves the excision of the ligamentum flavum [13]. ATTRwt in the ligamentum flavum has been reported in 33–45% of the patients undergoing surgery for SS; its prevalence has been associated with increased age and increased thickness of ligamentum flavum, suggesting a pathologic role in this process [9–11,14]. However, evaluation for concurrent cardiac amyloidosis was not undertaken until recently. In a recently published study by Eldhagen et al., 250 patients were evaluated for amyloid deposition in the ligamentum flavum, of which 93 (37%) were identified to have ATTR deposition and cardiac investigations did not reveal any involvement with amyloidosis.