No abstract available.
Diagnosis* ; Low Back Pain*

No abstract available.
Diagnosis* ; Humans ; Low Back Pain*

No abstract available.
Diagnosis* ; Humans ; Low Back Pain*

A technique radiogrequency localization and coagulation of articular nerves supplying the lumbar facets is described and reported from a series of 46 patients with clinical diagnosis of facet syndrome over a 4-year period. None of them had clinical or radiologic evidence of a lumbar disc hrniation, and all had exhausted conservative treatment. The literature reviewed for anatomical accuracies in denervation of the medial branch of posterior primary(dorsal) ramus. The technique of facet denervation is simple and safe and relief of pain was achieved in 78% of the patient, the morbidity remains quite low.
Denervation* ; Diagnosis ; Humans ; Low Back Pain*

OBJECTIVE: A new point of view on the chronic back pain proposed which is, named neuropathic back pain(NBP). Some proposed a certain pain scale as an useful diagnostic tool. Before scientific verification, some doctors prescribed a new anticonvulsant for the NBP. We investigated diagnostic tools for NBP by a review of the literature. METHODS: A comprehensive computer search of the English literature concerning neuropathic low back pain was performed using the key words such as neuropathic back pain and diagnosis in the PubMed. RESULTS: In 1998, the term NBP was first used in a patient with lung cancer. In the English literature, there were two diagnostic methods for the NBP, Neuropathic pain scale(NPS) and a pharmacological test. NPS is a pain questionnaire, which depends on the patients'subjective reports on the given questions, such as 'how hot is your pain feel'. By the pharmacological test, NBP was defined as 50% or more decrease of pain on intravenous lidocaine and on local anesthetic epidurally. It also depends on the patients'subjective response to the therapy. CONCLUSION: There were still no reliable objective diagnostic criteria for the NBP. It seems to be better to reserve the new anticonvulsants for the NBP till scientific approval.
Anticonvulsants ; Back Pain* ; Diagnosis ; Humans ; Lidocaine ; Low Back Pain ; Lung Neoplasms ; Neuralgia ; Pain Measurement ; Surveys and Questionnaires

Dorsal extradural migration of extruded disc material is clinically uncommon. We report a rare case of posterior epidural migration of an extruded lumbar disc mimicking a facet cyst. A 32-year-old man was admitted to our institute with a 2-week history of severe low back pain and radiating pain in the left leg. The magnetic resonance (MR) images revealed a dorsally located, left-sided extradural cystic mass at the L2-3 level. The initial diagnosis was an epidural facet cyst because of the high signal intensity on MR images and its location adjacent to the facet joint. Intraoperatively, an encapsulated mass of soft tissue adherent to the dural sac was observed and excised. The pathological diagnosis was degenerated disc material. After surgery, the patient experienced complete relief from leg pain.
Adult ; Diagnosis ; Humans ; Leg ; Low Back Pain ; Zygapophyseal Joint

OBJECTIVETo evaluate the reliability of flexion-extension ratio (FER) of lumbar erector muscle in surface EMG for the diagnosis of nonspecific chronic low back pain.

METHODSAccording to diagnostic study strategies, 73 patients with chronic low back pain and 86 controls were recruited in this study, FER of lumbar erector muscle were recorded in surface EMG for all the subjects. The critical value of FER for the diagnosis of nonspecific chronic low back pain was selected according to the receiver operator characteristic curve by SPSS. Sensitivity, specificity and accuracy were calculated and analyzed as well.

RESULTSThe FER in patients group was significantly higher than that in the control group. The critical value of FER was 0.68 with sensitivity, specificity and accuracy was 78.1%, 95.3% and 87.4% respectively.

CONCLUSIONFER of lumbar erector muscle might be practically applied as an objective indicator on the diagnosis of nonspecific chronic low back pain in surface EMG.

There was a development of the diagnostic aids such as electromyography, discography, epidural venography, myelography, and CT in lumbar disc herniation. In 1984, Edgardo et al. described that the diagnosis of unusual extreme lateral disc herniation might be suggested by CT, but the diagnosis was made more certain with CT done after discography. Also, in 1986, Michael et al. reported,that the addition of CT to lumbar discography could help the clinician to obtain an anatomically valid diagnosis in people who, in spite of prior negative diagnosis evaluation, continue with significant clinical symptoms of low back pain and sciatica. The authors have studied 25 cases of CT after discography from July 1984 to June 1987. The results were as follows;1) CT after discography, which was a diagnostic method of direct visualization of nucleus pulposus herniation, shown same finding as previous CT in 16 cases and more accurate finding of herniated site snd size in 2 cases. 2) In one csse, the diagnosis of extreme lateral disc herniation, which was suggested by previous CT, made more certain with CT after discography. 3) There was false negative in 6 cases.
Diagnosis ; Electromyography ; Low Back Pain ; Methods ; Myelography ; Phlebography ; Sciatica

Segmentary mobility of the mobile lumbar spines upon a total of 90 cases was studied by means of the functional radiographic examination. Segmentary mobility was determined by Falconer method. The cases were divided into four groups as Group I, 20 cases, who had no symptoms on low back, Group II, 20 cases, who had herniated disc in L4-5 confirmed either by surgery or by myelography, Group III, 30 cases, who had low back pain and neurological signs of L5 root irritation, and Group IV, 20 cases, who had low back pain as well as neurological signs of S1 root irritation. The result of the analysis was concluded as follows: 1. Total mobility of the lumbar spine in group I was significantly higher than other groups. Large normal variation in segmentary mobility of the lumbar spine was found, however, the mean angle of the segmentary mobility was highest in L4-5 and higher in the order of L5-S1, L4-3, L3-2 and L2-1. 2. Total mobility of the lumbar spine in group II was markedly reduced compared with group I, however, proportion of the segmentary mobility of L4-5 versus total mobility of the lumbar spine was somewhat higher than that of group 3. Total mobility of the lumbar spine in group III was significantly reduced than group I and significantly higher than group II. Proportion of the segmentary mobility of L4-5 versus total mobility of the lumbar spine in group III was somewhat higher than group I and the same as group II. 4. Total mobility of the lumbar spine in group IV was reduced than group I and group III, and higher than group II. Proportion of the segmentary mobility of L5-S1 was significantly higher than any other group. 5. In the groups with low back pain and herniated disc, in other words, there was found relatively increased segmentary mobility in the affected lumbar segments in contrast to reduced mobility of the total lumbar segments.
Diagnosis ; Intervertebral Disc Displacement ; Low Back Pain ; Methods ; Myelography ; Spine

Intervertebral disc disease, encountered in term of its life history, represents on of the most complexing medicosurgical disorders. The discovery by Mixter and Barr in 1934, that an intraspinal protrusion of the intervertebral disc was sometimes the cause of lumbago and sciatica, was outstandingly important because it might proved a rational for the treatment of backache. The author has reviewed 1500 cases of disc surgery performed at Yonsei University, Sceverance Hospital from 1950 to 1971. A contrast myelography was carried out routineley and the day was attempted to remove as much as possible. Surgical treatment was underwent by laminectomy, partial hemi-or total, for the thoracic and lumbar discs and Cloward's anterior approach for cervical discs invariably. CONCLUSION: 1. Among the 1500 disc surgeries 90.2% were lumbar disc lesions; thoracic 0.1% and cervical 9.7%. The percentile of disc herniation between L4-5 verebrae was 62%; 27% between L5-S1 vertebrae. 24% of lumbar intervertebral disc herniations disclosed multiple lesion. C5-6 disc herniation was 58% and C6-7 lesion 27%, multiple cervical disc herniation was 27%. 2. A contrast myelography is an invaluable procedure for the diagnosis of a herniation of the nucleus pulposus. It is a considerably safe procedure with minimal complication when performed carefully. 3. For a central disc herniation surgical approach from both sides may preferably render a better result. 4. In case when the nucleus pulposus being protruded way laterally a decompression of the nerve root is mandatory in the foraminal and the disc interspace. 5. The posterior approach for the thoracic disc herniation may render a considerable damage to the spinal cord with subsequent paraparesis. The anterolateral or posterolateral procedure may give a better result. 6. 97.7% of lumbar disc surgery disclosed from an improvement to recovery. 7. The anterior approach for the cervical intervertebral discs gives a better result; 98% of the surgeries disclosed an improvement to recovery.
Back Pain ; Decompression ; Diagnosis ; Intervertebral Disc* ; Laminectomy ; Low Back Pain ; Myelography ; Paraparesis ; Sciatica ; Spinal Cord ; Spine