Lumbar disc extrusion –complete absorption

lumbar dusc total absorption

1. Lumbar disc Extrusion – an observational study Vinod Naneria Girish Yeotikar Arjun Wadhwani Choithram Hospital & Research centre, Indore, India Complete Absorption Part 1

2. Cochrane review Prolapsed lumbar discs – < 5% of all low-back problems. Ninety percent of acute attacks of sciatica settle with non-surgical management. Surgical options are usually considered for more rapid relief in the minority of patients whose recovery is unacceptably slow. The effects of surgical treatments for individuals with 'slipped' lumbar discs Gibson JA, Waddell G

3. Saal JA, Saal JS, Herzog RJ: The natural history of lumbar intervertebral disc extrusions treated non-operatively. Spine 15: 683–686, 1990 Patients with large compressive lesions are also generally believed to be more ideally suited to surgical intervention. These same patients, however, are those most likely to experience spontaneous regression of their lesions and they have a high rate of clinical improvement with noninvasive treatments.

4. Asraf Beg – case summary 40 yr, M, short statured, obese DM + HT Acute PID L4 – L5 rt <1wk Nil neurology at admission MRI – Nov 2010 extruded disc Tx - Conservative Develop ankle jerk loss and EHL gr2 in one wk Follow up MRI – Feb 2011 Last follow up – Sept 2012 Case summary - 1 Total absorption

5. Complete absorption in three months Case summary - 2

6. Complete absorption Case summary - 3

7. Complete absorption Case summary - 4

8. Complete absorption Case summary - 5

9. Complete regression Case summary - 6

10. Complete regression Case summary - 7

11. Absorption of loose piece within one month Case summary - 8

12. Case summary - 9 Total absorption

13. Regression of extrusion Case summary - 10

14. Case summary - 11 Total absorption

15. Case summary - 12 Total absorption

16. Case summary - Case summary - 13 Total absorption

17. Total regression Case summary - 14

18. Total regression of loose piece Case summary - 15

19. Total absorption

20. Total regression Case summary - 16

21. Case summary - 17

22. References – same authors http://www.slideshare.net/naneria/t1-t2-extruded-disc-case-report-14076043 http://www.slideshare.net/naneria/lumbar-disk-update-presentation http://www.slideshare.net/naneria/free-fragments-lumbar-spine-148466 http://www.slideshare.net/orthonet/lumbar-disc-herniation-naneria-part-1 http://www.slideshare.net/orthonet/lumbar-disc-herniation-naneria-part-2 http://www.authorstream.com/Presentation/naneria-23060-Free-fragments-lumbar-canal-LumbarCanal-fragment-Literature-Migration-Composition-extruded-materia-Education-ppt-powerpoint/

23. Disclaimer All photographs were taken with the consent of the all patients. Clinical photos were also put with due verbal permission. This presentation strictly for students of orthopedics with the sole idea of propogating knowledge. Any objection as for photographs or x-rays, please inform [email protected] for prompt deletion. Material collected from C.H.& R.C., Indore and from private clinics of the authors.

24. DISCLAIMER Information contained and transmitted by this presentation is based on personal experience and collection of cases at Choithram Hospital & Research centre, Indore, India, during last 25 years. It is intended for use only by the students of orthopaedic surgery. Views and opinion expressed in this presentation are personal opinion. Depending upon the x-rays and clinical presentations viewers can make their own opinion. For any confusion please contact the sole author for clarification. Every body is allowed to copy or download and use the material best suited to him. I am not responsible for any controversies arise out of this presentation. For any correction or suggestion please contact [email protected]