Cases reported "Sciatica"

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1/5. Nerve root herniation secondary to lumbar puncture in the patient with lumbar canal stenosis. A case report.

    STUDY DESIGN: A very rare case of nerve root herniation secondary to lumbar puncture is reported. OBJECTIVE: To describe the characteristic clinical features of this case and to discuss a mechanism of the nerve root herniation. SUMMARY OF BACKGROUND DATA: There has been no previous report of nerve root herniation secondary to lumbar puncture. methods: A 66-year-old woman who experienced intermittent claudication as a result of sciatic pain on her right side was evaluated by radiography and magnetic resonance imaging, the results of which demonstrated central-type canal stenosis at L4-L5. The right sciatic pain was exacerbated after lumbar puncture. myelography and subsequent computed tomography showed marked stenosis of the thecal sac that was eccentric to the left, unlike the previous magnetic resonance imaging finding. RESULTS: At surgery, a herniated nerve root was found through a small rent of the dorsocentral portion of the thecal sac at L4-L5, presenting a loop with epineural bleeding. The herniated nerve root was put back into the intrathecal space, and the dural tear was repaired. CONCLUSION: Lumbar puncture can be a cause of nerve root herniation in cases of lumbar canal stenosis. The puncture should not be carried out at an area of stenosis.
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2/5. Chronic inflammatory granuloma mimics clinical manifestations of lumbar spinal stenosis after acupuncture: a case report.

    STUDY DESIGN: A case report and review of the literature. OBJECTIVES: To present a case of chronic inflammatory epidural granuloma formed after acupuncture. SUMMARY OF THE BACKGROUND DATA: A number of cases of complications resulting from acupuncture have been reported, including acute infection, hemorrhage, and direct injury to internal organs or neural tissues. However, to the best of our knowledge, there has been no report of epidural granuloma formed following acupuncture and mimicking clinical manifestations of lumbar stenosis. methods: A 68-year-old woman suffered from low back pain and sciatica aggravated by acupuncture. We reviewed her medical record, imaging studies, microscopic findings of the mass, and related literature. RESULTS: Microscopic examination revealed the mass as a chronic inflammatory granuloma. From her previous history and imaging study, the mass, which compressed the lumbar forth nerve and dural sac,was highly suspected to have been formed after acupuncture. Surgical decompression and excision of the epidural mass relieved her symptoms. CONCLUSION: Chronic inflammatory granuloma may be formed as a complication of acupuncture. Under such circumstances, surgical excision of the mass may be an effective way of relieving the symptoms.
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3/5. Post-lumbar puncture arachnoiditis. The need for directed questioning.

    The inflammation of the arachnoid mater may produce a fibrinous exudate around the roots that causes them to adhere to the dural sheath. We report the case of a man aged 23 years who suffered from acute inflammatory truncated sciatica. The diagnosis of adhesive arachnoiditis was made in front of clinical arguments associated to typical signs on Myelo CT Scan and MRI. The only explanation ever found was a traumatic lumbar puncture at the age of 6 years for suspected meningitis. Sequelae of arachnoiditis are difficult to diagnosis. When MRI or myelography suggests it as a possibility, precise directed questioning is necessary to seek a history, albeit distant, of spinal or meningeal events.
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4/5. electroacupuncture direct to spinal nerves as an alternative to selective spinal nerve block in patients with radicular sciatica--a cohort study.

    We applied electroacupuncture to the spinal nerve root by inserting needles under x ray imaging in three cases with radicular sciatica, as a non-pharmacological substitute for lumbar spinal nerve block. In all three cases, symptoms were markedly reduced immediately after electroacupuncture to the spinal nerve root. The sustained effect was noticeably longer than that of spinal nerve blocks previously performed, in two out of the three cases. We suggest that descending inhibitory control, inhibitory control at the spinal level, inhibition of potential activity by hyperpolarisation of nerve endings, or changes in nerve blood flow may be involved in the mechanism of the effect of electroacupuncture to the spinal nerve root. These results suggest that electroacupuncture to the spinal nerve root may be superior to lumbar spinal nerve block when it is applied appropriately in certain cases of radicular sciatica, taking into consideration patient age, severity of symptoms and duration of the disorder.
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5/5. Treatment for lumbar sciatic pain in posterior articular lumbar joint syndrome.

    One-hundred-and-fifty-four selected patients aged 19--80 years with lumbar sciatic pain of 2-week-30-year duration, treated with percutaneous rhizolysis, epidural block and acupuncture are reviewed. One-hundred-and-eighteen (76.6%) patients were significantly relieved of their pain. One-hundred-and-twenty-two patients (79.2%) underwent rhizolysis. All 154 patients had been previously treated by an orthopaedic surgeon.
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