China
Africa
Explore chapters and articles related to this topic
Evaluation of the Spine in a Child
Published in Nirmal Raj Gopinathan, Clinical Orthopedic Examination of a Child, 2021
Ashish Dagar, Sarvdeep Singh Dhatt, Deepak Neradi, Vijay G Goni
On the one hand, axial pain is a marker of ligamentous, osseous, muscular, joint, and annular pathologies. Radicular pain, on the other hand, is usually caused by irritation of neurological tissue due to compression because of an etiology like disc fragment, canal stenosis, and foraminal stenosis. Patients with nerve root symptoms usually present with paresthesia, hyperalgesia, tingling, numbness, and burning pain. Patients with cervical radiculopathy usually obtain relief on abduction of the ipsilateral shoulder, while a patient with shoulder pathology usually has painful abduction of the shoulder. The pelvic cause of low back pain must be considered in differential diagnosis, particularly sacroiliitis. Pathology in retroperitoneal structures like the kidney, ureter, pancreas, etc. can present as back pain.
Pediatric Spinal Tumors
Published in David A. Walker, Giorgio Perilongo, Roger E. Taylor, Ian F. Pollack, Brain and Spinal Tumors of Childhood, 2020
Rajiv R. Iyer, Nir Shimony, Mohammad Hassan A. Noureldine, Eric Bouffet, George I. Jallo
Symptomatic nerve sheath tumors warrant surgical resection. Radicular pain is a common presenting symptom for such lesions. In the case of multiple lesions, such as in neurofibromatosis, careful preoperative history, examination, and workup are needed to identify the symptomatic lesion that requires an intervention. Schwannomas arise from the Schwann cells within a nerve root sleeve, and tumor dissection from a nerve fascicle is possible due to its encapsulated nature. With neurofibromas, circumferential root expansion occurs, and tumor resection typically involves root sacrifice. Fortunately, in the majority of cases of nerve sheath tumors, a sensory root is affected, and significant neurological impairment can be avoided, even in cases of a parent root sacrifice. In some cases, tumors extend through the neuroforamen and are thus classified as both intra- and extradural. Staged resection may be necessary to remove such lesions, or transforaminal approaches may require fusion in addition to tumor resection.
Revision high-grade spondylolisthesis surgery
Published in Gregory D. Schroeder, Ali A. Baaj, Alexander R. Vaccaro, Revision Spine Surgery, 2019
Reasonable expectations on the part of both the patient and the surgeon are a key element in achieving a good outcome. Depending on the chronicity, intensity, and underlying cause of a patient's pain, even a flawless surgery may not lead to complete symptomatic relief. Radicular pain due to ongoing physical irritation is likely to improve significantly or completely with surgical decompression unless it is chronic. Response to epidural or nerve root injections and, to a lesser degree, oral medications such as ibuprofen or gabapentin can help with prognostication of the outcome.
Digital physical therapy practice and payment during the COVID-19 pandemic: A case series
Published in Physiotherapy Theory and Practice, 2023
For Patient 3, treatment occurred entirely by telehealth. Prone press-ups were provided as a home program to be performed until centralization to the lower back could occur. The patient was educated on the favorable prognosis of acute radicular pain (Konstantinou et al., 2018) and advised to remain active. A plan to walk twice daily in her neighborhood was also established. At the first follow-up visit, she had no pain with AROM testing and had not experienced leg pain since her last visit. Her home program was updated to emphasize global strengthening and motor control because she was observed having difficulty getting up from the floor and was unable to go to the gym due to stay-at-home orders. At her second follow-up visit 2 weeks later, the patient reported being ready for discharge. At this point, she had been asymptomatic for nearly 2 weeks. The physical therapist determined that discharge was appropriate, and an exercise program for general conditioning was prescribed.
Evaluation of the patients diagnosed as idiopathic intracranial hypertension with and without papilledema visual pathways by analysis of visual evoked potential
Published in International Journal of Neuroscience, 2021
Ayşin Kisabay, Deniz Selcuki, Sinem Zeybek, Melike Batum
A minority of the patients may experience radicular pain and symptoms of neck pain [5]. Its mechanism is thought to be distention of sheaths of spinal nerve root from elevated CSF pressure [14]. In the group with papilledema, IIH was accompanied by tension headache in 16 (27%) patients and by migraine in 9 patients (15%) while in the group without papilledema it was accompanied by chronic migraine in 5 (8%), cervicogenic headache in 2 (3%), cluster headache in 1 (2%) and migrainous headache in 2 (3%) patients. Migrainous features were more prominent in the group without papilledema while migraine was associated with tension headache in the group with papilledema. Severity of headache may or may not correlate with CSF pressure [17]. In the group without papilledema, the headache was less severe and opening pressure of LP was lower. Mathew et al. reviewed 85 patients with IIH and saw that no papilledema was accompanying to IIH in 10 patients [18]. In 6% of the patients, no clinical papilledema is seen despite optic nerve injury [19].
Different kinetics of infectious processes in vertebral osteomyelitis of pyogenic or tuberculous origin explain different timing of surgery
Published in Infectious Diseases, 2020
Ségolène Perrineau, Virginie Zarrouk, Mohamed Zoghlami, Wassim Allaham, Véronique Leflon-Guibout, Marc-Antoine Rousseau, Bruno Fantin
Vertebral osteomyelitis (VO) is an infection of the spine with heterogeneous clinical presentations [1,2]. Haematogenous pyogenic vertebral osteomyelitis (HPVO) is the leading cause of osteomyelitis in adults over 50 years of age [2], and Staphylococcus aureus is the predominant pathogen [1]. As HPVO is associated with significant morbidity, including decreased functional status, and mortality, early diagnosis and prompt management are crucial [1–4]. Up to 30% of patients present neurological complications, encompassing radicular pain, sensibility disorders, sphincter abnormalities or motor weakness [5]. Neurological deficits persist in about 30% of cases presenting with neurological complication at presentation [5–7]. S. aureus, the presence of epidural abscesses and cervical/thoracic location are risk factors for severe neurological deficits [5].