Information on Herniated Disc fom the National Library of Medicine
Your backbone, or spine, is made up of 26 bones called vertebrae. In between them are soft disks filled with a jelly-like substance. These disks cushion the vertebrae and keep them in place. A herniated disk is a disk that slips out of place or ruptures. If it presses on a nerve, it can cause back pain or sciatica. Read more at NLM.
A Herniated Disk Guide from the Mayo Clinic
MayoClinic.com herniated Disk information
Information on Herniated Discs from the American Academy of Orthopaedic Surgeons
When people say they have a "slipped" or "ruptured" disk in their neck or lower back, what they are actually describing is a herniated disk-a common source of pain in the neck, lower back, arms, or legs…Read more at the American Academy of Orthopaedic Surgeons.
Information on Cervical Radiculopathy from the American Academy of Orthopaedic Surgeons
Usually, when something hurts, you do not have to look far to find the source of the pain. But an injury near the root of a nerve can result in pain at the end of the nerve where sensation is felt. For example, an injury to the vertebrae or disks in your neck (cervical vertebrae) can result in pain, numbness, or weakness in your shoulder, arm, wrist, or hand because the nerves that extend out from between the cervical vertebrae provide sensation and trigger movement in these areas. This condition is called cervical radiculopathy. Read more at the American Academy of Orthopaedic Surgeons.
Low Back Pain Fact Sheet
If you have lower back pain, you are not alone. Nearly everyone at some point has back pain that interferes with work, routine daily activities, or recreation. Americans spend at least $50 billion each year on low back pain, the most common cause of job-related disability and a leading contributor to missed work. Back pain is the second most common neurological ailment in the United States...Read more at the National Institute of Neurologic Disorders and Stroke.
FactSheet: Minimally Invasive Spine Surgery
In minimally invasive spine surgery, surgeons make small incisions, usually with the aid of microscopes or endoscopic visualization (very small devices or cameras designed for viewing internal portions of the body).
This inside view of the patient’s body is projected onto television screens in the operating room...Read more at the George Washington University Hospital.
Animation: Anterior Lumbar Interbody Fusion
View procedural animations at Midwest Orthopaedics at Rush.
Interactive Tool: Chronic Back Pain Symptom Check-up
Visit an online interactive virtual doctor presented by freemd.com.
Podcast: Disc Disease - Minimally Invasive Surgery
Minimally invasive surgery for disc disease helps patients recover a normal lifestyle much more quickly than fixation and fusion techniques. Dr. Bart Sachs describes that approach in this podcast from the medical University of South Carolina.
Video: Herniated Disc
A herniated disc occurs when the disc degenerates and the inner core leaks out. This puts pressure directly on the spinal nerve root, which in turn can prompt back pain and symptoms of sciatica. This interactive video allows you to see what a typical lumbar herniated disc looks like.View the video at spine-health.com.
Video: Treatments for Ruptured Discs in the Neck
Herniated disc in the neck. Dr. Scott Middlebrooks, an orthopedic surgeon, discusses treatment of disc disease in the neck, including conservative treatment and surgical treatment, as well as advances in the surgical treatment of a herniated disc in the neck...View the video at videomd.com.
Podcast: Rehabilitation after lumbar disc surgery
Raymond Ostelo talks about the rehabilitation and what to do after surgery.
Video: Keys to Exercise video series
A series of exercise videos provided by the American College of Sports Medicine.
Adult low back pain
Objectives: To improve the assessment and reassessment of adult patients with low back pain; To reduce unnecessary imaging in adult patients with low back pain in the absence of "red flag" indicators or progressive symptoms; To increase the use of the recommended conservative approach as first-line treatment, such as activity, self-care, and analgesics for adult patients with low back pain.
See National Guideline Clearinghouse major recommendations.
Neck and upper back (acute & chronic)
Objectives: To offer evidence-based step-by-step decision protocols for the assessment and treatment of workers' compensation conditions. See National Guidelines Clearinghouse major recommendations .
Guidelines for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 8: lumbar fusion for disc herniation and radiculopathy
Objective: To examine the medical evidence concerning the role of lumbar fusion in the operative treatment of patients with radiculopathy and back pain caused by a herniated lumbar intervertebral disc. See National Guidelines Clearinghouse major recommendations.
Acupuncture and electroacupuncture: evidence-based treatment guidelines
Objectives: To establish evidence-based best practice guidelines for acupuncture and electroacupuncture to be utilized by practitioners, patients, regulators, and third-party payors to make health-related decisions that result in medically sound treatment approaches that lead to effective and reproducible outcomes in the clinical setting. See National Guideline Clearinghouse major recommendations.
Diagnosis and treatment of low back pain: A joint clinical practice guideline from the American College of Physicians and the American Pain Society
Objective: To present the available evidence for evaluation and management of acute and chronic low back pain in primary care settings. See National Guideline Clearinghouse major recommendations.
Abstract: Cervical disc arthroplasty compared with arthrodesis for the treatment of myelopathy. Surgical technique
BACKGROUND: Although there have been case reports describing the use of cervical disc arthroplasty for the treatment of myelopathy, there is a concern that motion preservation may maintain microtrauma to the spinal cord, negatively affecting the clinical results. As we are not aware of any studies on the use of arthroplasty in this scenario, we performed a cross-sectional analysis of two large, prospective, randomized multicenter trials to evaluate the efficacy of cervical disc arthroplasty for the treatment of myelopathy. Read abstract at PubMed.
Abstract: Disc prolapse: evidence of reversal with repeated extension
STUDY DESIGN: A basic science study that used a porcine cervical spine model to produce disc prolapse subsequently exposed to an extension protocol. OBJECTIVE: This study investigated whether extension or combined extension and side flexion could move the displaced portion of nucleus from the anulus towards the nucleus. Read more at PubMed.
Effectiveness of percutaneous laser disc decompression versus conventional open discectomy in the treatment of lumbar disc herniation; design of a prospective randomized controlled trial
The usual surgical treatment of refractory sciatica caused by lumbar disc herniation, is open discectomy. Minimally invasive procedures, including percutaneous therapies under local anesthesia, are increasingly gaining attention. One of these treatments is Percutaneous Laser Disc Decompression (PLDD). This treatment can be carried out in an outpatient setting and swift recovery and return to daily routine are suggested. Thus far, no randomized trial into cost-effectiveness of PLDD versus standard surgical. procedure has been performed. We present the design of a randomized controlled trial, studying the cost-effectiveness of PLDD versus conventional open discectomy in patients with sciatica from lumbar disc herniation. Full text available free through PubMed.
Surgical versus Non-Operative Treatment for Lumbar Disc Herniation: Four-Year Results for the Spine Patient Outcomes Research Trial (SPORT)
Lumbar disc surgery remains one of the most commonly performed operations, with rates exhibiting considerable geographic variation.1 Two recent randomized trials demonstrated that surgery provides faster pain relief and perceived recovery in patients with herniated disc.2–4 Outcomes were similar at 1 year for patients assigned to surgery and for those assigned to non-operative treatment. However, both trials included substantial numbers of surgical patients in the non-operative comparison arm due to treatment crossover, affecting the interpretation of the intent-to-treat analyses. This paper reports 4-year results for SPORT based on the continued follow-up of the herniated disc randomized and observational cohorts. Full text available free through PubMed.
Abstract: Efficacy of lumbosacral transforaminal epidural steroid injections: a systematic review.
OBJECTIVE: To critically review the best available studies evaluating the efficacy of lumbosacral transforaminal epidural steroid injections (TFESIs) in the treatment of radicular pain. See abstract at PubMed.
Abstract: The outcomes of lumbar microdiscectomy in a young, active population: correlation by herniation type and level.
STUDY DESIGN: Prospective longitudinal clinical study. OBJECTIVE: The purpose of our article was to investigate the clinical outcomes with type and level of disc herniation in a young, active population undergoing lumbar microdiscectomy. SUMMARY OF BACKGROUND DATA: There are few reported outcomes studies on the relationship between disc herniation level, type of disc herniation, and surgical outcomes of lumbar microdiscectomy in a young, active population. See abstract at PubMed.
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