61. Disk Herniation In Children And Adolescents She presented with localized low back pain and was diagnosed with lumbar strain. ring apophysis avulsion directly associated with a central disc http://gait.aidi.udel.edu/res695/homepage/pd_ortho/educate/clincase/disc.htm

DISK HERNIATION IN CHILDREN AND ADOLESCENTS DEAN HARTER, M.D., Resident, Orthopaedic Surgery KIRK W. DABNEY, M.D., Attending, Pediatric Orthopaedic Surgery April 3, 1996 CLINICAL CASE PRESENTATION ORTHOPAEDIC DEPARTMENT THE ALFRED I. DUPONT INSTITUTE WILMINGTON, DELAWARE Case History This 17 year old white female was involved in an automobile accident. She presented with localized low back pain and was diagnosed with lumbar strain. Her pain increased despite maximum physical therapy. At approximately 6 weeks post injury, she noted the onset of right leg radiation in an S1 distribution. She also experienced occasional paresthesias in the same area. Her LBP decreased at this point. She denied LE weakness or bowel/bladder dysfunction. Physical Examination decreased lumbar flexion Right list with forward bending no localized tenderness or spasm Straight Leg Raise test was positive at 45 degrees negative contralateral Straight Leg Raise test positive Lasegue's sign no focal neurological findings Radiological Evaluation plain x-rays normal, with mild spinal curve

62. Arquivos De Neuro-Psiquiatria - lumbar DISC HERNIATION ASSOCIATED WITH SCOLIOSIS IN A 15YEAR-OLD GIRL Epstein AJ, Epstein NE, Marc J. lumbar intervertebral disk herniation in teenage http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2002000200022

63. Guam Medical Libraries Digital Libraries Program lumbar (Intervertebral) disk Disorders Access document; Back Pain, Mechanical Access document lumbar Disc Disease (Keyword search) List of documents http://guam-dl.slis.ua.edu/clinical/orthopedics/back/lumbar-disc-disease.htm

Clinical Resources by Topic: Orthopedics Lumbar Disc Disease Clinical Resources Emergency Pediatrics Radiology Physical/Rehabilitation ... Miscellaneous Resources See also: Musculoskeletal Clinical Procedure Resources General Orthopedics Clinical Resources Lumbar Disc Disease Patient/Family Resources Harris: Kelley's Textbook of Rheumatology 7th Ed.-2005 (MD Consult): Table of contents Medical Library subscription INFO Section V - Evaluation of Generalized and Localized Symptoms: Access document Chapter 39 - Low Back Pain: Access document Introduction: Access document Epidemiology: Access document Biology: Access document Clinical Presentation: Access document Classification: Access document Natural History: Access document Management: Access document Special Considerations: Access document Outcome: Access document References: Access document Canale: Campbell's Operative Orthopaedics 10th Ed.-2003 (MD Consult): Table of contents Medical Library subscription INFO Chapter 34 - Spinal Anatomy and Surgical Approaches: Access document Anatomy of Vertebral Column: Access document Anatomy of Cervical, Thoracic, and Lumbar Pedicles:

64. Lumbar Herniated Disc lumbar herniated disc overview of causes and treatments, by SpineHealth. http://www.spine-health.com/topics/cd/overview/lumbar/young/lum01.html

Introduction Common causes Conservative care Surgery ... Anatomy Search Common causes of back pain and neck pain Back pain introduction Lumbar spine: Young adult causes: Lumbar herniated disc Degenerative disc disease Isthmic spondylolisthesis Older adult causes: Facet joint osteoarthritis Lumbar spinal stenosis Degenerative spondylolisthesis Miscellaneous causes Figures Fig. 1: Lumbar Disc Herniation larger view Fig. 2: MRI of Lumbar Disc Herniation) larger view Spine animations Lumbar herniated disc Lumbar microdecompression (microdiscectomy) back surgery Related information Insights and advice about herniated discs Treatment options for a lumbar herniated disk Lumbar artificial disc surgery for chronic back pain Multi-specialy caseherniated disc ... The doctor is in! - Lumbar herniated disc surgery

65. Lumbar Herniated Disc Animation Animation of a lumbar herniated disc and how disc herniation causes low back pain and leg pain, by SpineHealth. http://www.spine-health.com/dir/hern.html

Interactive Spine Animations Search Related information Insights and advice about herniated discs Lumbar disc herniation What you need to know about sciatica What is a herniated disc, pinched nerve, bulging disc...? Find a Doctor Choose a state Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Germany United Kingdom Lumbar herniated disc animation This animation allows you to see what a typical lumbar herniated disc looks like. A herniated disc in the lower back can cause lower back pain and/or leg pain (sciatica) by putting pressure on the nerve root.

66. Herniated Lumbar Disc Most disc herniations occur in the bottom two discs of the lumbar spine, A herniated lumbar disc can press on the nerves in the spine and may cause pain http://www.spine.org/articles/herniatedlumbardisc.cfm

Herniated Lumbar Disc While a disc herniation may sound serious, most people recover and return to their normal lifestyle within several weeks or months without having surgery. There may still be some symptoms, but most patients can function well. What is it? Available Treatments Medical Treatments Surgical Treatments Get professional supervision early to so your doctor can prescribe the right regimen of medication, physical therapy, exercise, posture modification and physical activity. Accurate diagnosis and early management may help you recover faster. Keep the use of pain medications to a minimum. All medications should be taken as directed. Tell your doctor of any changes in your symptoms so treatment can be changed if necessary. Call your doctor immediately if you have loss of bladder or bowel control or numbness in the genital area in addition to your pain. What Is A Herniated Disc? The spine is made up of a series of connected bones called "vertebrae". The disc is a combination of strong connective tissues which hold one vertebra to the next, and acts as a cushion between the vertebrae. The disc is made of a tough outer layer called the "annulus fibrosus" and a gel-like center called the "nucleus pulposus." As you get older, the center of the disc may start to lose water content, making the disc less effective as a cushion. This may cause a displacement of the disc’s center (called a herniated or ruptured disc) through a crack in the outer layer. Most disc herniations occur in the bottom two discs of the lumbar spine, at and just below the waist.

67. EMedicine - Lumbar Disc Disease : Article By Kamran Sahrakar, MD lumbar Disc Disease lumbar disc disease accounts for a large amount of lost productivity in the workforce. Accurate diagnosis can be difficult and often http://www.emedicine.com/med/topic2902.htm

(advertisement) Home Specialties Resource Centers CME ... Patient Education Articles Images CME Patient Education Advanced Search Consumer Health Link to this site Back to: eMedicine Specialties Medicine, Ob/Gyn, Psychiatry, and Surgery Neurosurgery Lumbar Disc Disease Last Updated: September 6, 2002 Rate this Article Email to a Colleague Synonyms and related keywords: degenerative disc disease, lumbar disc herniation, sciatica, radiculopathy, lumbar discectomy, back pain, cauda equina syndrome AUTHOR INFORMATION Section 1 of 10 Author Information Introduction Indications Relevant Anatomy And Contraindications ... Bibliography Author: Kamran Sahrakar, MD , Clinical Professor, Department of Neurosurgery, University of California-Davis Coauthor(s): Martin Melicharek, MD , Assistant Clinical Professor, Department of Neurosurgery, University of California at Davis Kamran Sahrakar, MD, is a member of the following medical societies: Alpha Omega Alpha American Association of Neurological Surgeons American Medical Association California Medical Association ... Florida Medical Association , and Nevada State Medical Association Editor(s): Michael G Nosko, MD, PhD

68. Clinical Evaluation And Treatment Options For Herniated Lumbar Disc - February 1 Illustrated discussion of causes of disc herniation, assessment, imaging procedures and both surgical and nonsurgical treatment. http://www.aafp.org/afp/990201ap/575.html

Advanced Search AAFP Home Page Journals Vol. 59/No. 3 (February 1, 1999) Clinical Evaluation and Treatment Options for Herniated Lumbar Disc S. CRAIG HUMPHREYS, M.D., and JASON C. ECK, M.S. Chattanooga, Tennessee A patient information handout on herniated lumbar disc, written by the authors, is provided on page 587. Degeneration of the intervertebral disc from a combination of factors can result in herniation, particularly at the L4-5 and L5-S1 levels. The presence of pain, radiculopathy and other symptoms depends on the site and degree of herniation. A detailed history and careful physical examination, supplemented if necessary by magnetic resonance imaging, can differentiate a herniated lumbar disc from low back strain and other possible causes of similar symptoms. Most patients recover within four weeks of symptom onset. Many treatment modalities have been suggested for lumbar disc herniation, but studies often provide conflicting results. Initial screening for serious pathology and monitoring for the development of significant complications (such as neurologic defects, cauda equina syndrome or refractory pain) are essential in the management of lumbar disc herniation. T he intervertebral disc is responsible for the attachment of vertebral bodies to each other, providing flexibility and absorbing and distributing the loads applied to the spinal column. With aging, the disc undergoes significant changes in volume and shape as well as in biochemical composition and biomechanical properties. Lumbar disc herniations are believed to result from anular degeneration that leads to a weakening of the anulus fibrosus, leaving the disc susceptible to anular fissuring and tearing.

69. Lumbar Disc Herniation, HNP, Dr. Jho's Lumbar Disc Surgery Via A Tiny Trocar Dr, Jho has developed minimally invasive endoscopic lumbar disc surgery through a small incision either at the posterior midline or at the posterolateral http://drjho.com/lumbar_disc_surgery.htm

var TlxPgNm='lumbar_disc_surgery'; Jho Institute for Minimally Invasive Neurosurgery H ome Staff Overview ... Directions and Contact Be Careful ! Spine Diseases Cervical disc herniation Cervical stenosis Thoracic disc herniation Lumbar disc herniation Lumbar stenosis Spinal cord tumors Occipital neuralgia Spinal instability Chiari malformation Hyperhidrosis Brain Diseases Pituitary tumors Cushing's Disease Acoustic neuromas Meningiomas Craniopharyngiomas Pineal tumors Skull base tumors Chordomas Arachnoid cysts Colloid cysts Hydrocephalus Trigeminal neuralgia Hemifacial spasm Vertigo and tinnitus Glossopharyngeal neuralgia Spasmodic torticollis Cerebral aneurysms Lumbar Disc Herniation, HNP, Dr. Jho's Lumbar Disc Surgery via a Tiny Trocar Dr. Jho 's Minimally Invasive Lumbar Disc Surgery: Endoscopic Lumbar Discectomy: Low Back Surgery Hae Dong Jho, M.D., Ph.D., Professor of Neurosurgery Jho Institute for Minimally Invasive Neurosurgery In order to make lumbar disc surgery minimally invasive, Dr. Jho adopted an endoscope for lumbar discectomy. Two different surgical approaches are used depending on the location of the pathology and clinical situation: (1) Posterior, and (2) Posterolateral. Posterior endoscopic discectomy is the first approach, which is performed with a small skin incision made at the midline posterior lumbar region. A small trocar is inserted towards the herniated disc. The herniated disc material is removed under the direct endoscopic visualization. The disc located between the spinal bone is preserved as much as possible in order to maintain the spinal integrity.

70. Lumbar Disc Herniation Surgery: Dr. Jho's Endoscopic Lumbar Discectomy Minimally invasive endoscopic lumbar disc surgery has been developed by Dr. Jho, Professor of Neurosurgey, through a small incision either at the posterior http://drjho.com/id32.htm

var TlxPgNm='id32'; Jho Institute for Minimally Invasive Neurosurgery home Staff Overview Table of contents ... Directions and Contact Spine Diseases Cervical disc herniation Cervical stenosis Thoracic disc herniation Lumbar disc herniation Lumbar stenosis Spinal cord tumors Occipital neuralgia Spinal instability Chiari malformation Hyperhidrosis Brain Diseases Pituitary adenomas Cushing's Disease Acoustic neuromas Meningiomas Craniopharyngiomas Pineal tumors Skull base tumors Chordomas Arachnoid cysts Colloid cysts Hydrocephalus Trigeminal neuralgia Hemifacial spasm Vertigo and tinnitus Glossopharyngeal neuralgia Spasmodic torticollis Cerebral aneurysms Lumbar Disc Herniation Surgery: Dr. Jho's Endoscopic Lumbar Discectomy Dr. Jho 's Minimally Invasive Lumbar Disc Surgery: Endoscopic Lumbar Discectomy: Low Back Surgery Hae Dong Jho, M.D., Ph.D., Professor of Neurosurgery Jho Institute for Minimally Invasive Neurosurgery Lumbar disc surgery has evolved from total laminectomy to microdiscectomy technique over a century. While various attempts and efforts have been made to improve lumbar disc surgery, lumbar disc surgery has been a continual prime subject of spine surgeons' research. In order to make lumbar disc surgery minimally invasive, Dr. Jho

71. Volumes Of Degenerated Lumbar Intervertebral Disks Determined From Volumetric Im A study on the volumes of degenerated lumbar intervertebral disks determined from volumetric image analysis. http://www.spineuniverse.com/displayarticle.php/article536.html

The World Leader in Patient Education Home Patients Professionals My Account ... Resources SEARCH professional>devices>surgical>low back> Volumes of Degenerated Lumbar Intervertebral Disks Determined From Volumetric Image Analysis Jason A. Heth, MD J Haller, PhD T Ryken, MD (Iowa City, IA) Introduction: Methods: Results: Discussion/Conclusions: These are initial results in volumetric analysis of diseased intervertebral disks. Future directions of this work include correlation with radiographic degree of disk degeneration with measured volumes and surface analysis of the vertebral endplates. This may serve to improve instrumentation interaction with adjacent vertebral bodies. //This is the TOP Skyscraper DisplayAds ("Right1,Top!Top", "468", "60") Long-term Efficacy of GRAF Soft Fixation and PLIF with Cages in Multiple Spondylotic Stenosis in Lumbar Spine A Prospective Study of Calcium Sulfate Pellets as Bone Graft Extenders in Lumbar Posterolateral Arthrodesis Are Epidural Steroids Useful? In Vitro Evaluation of Self-Centering Pedicle Screws Using Computer-Aided Surgery Techniques ... Robotically Assisted Laparoscopic Anterior Lumbar Interbody Fusion Article written 08/03/2000 Published online 08/03/2000 Last updated: 08/29/2005 //This is the Right Skyscraper DisplayAds ("Right1,Top!Right1", "120", "600")

72. Artificial Lumbar Disc Current Treatment Options for lumbar Disc Disease Consequently, patients undergoing placement of an artificial lumbar disc may need less surgeries on http://www.spinalneurosurgery.com/artificial_lumbar_disc.htm

SEE PATIENT RESOURCES ON ARTIFICIAL DISC SURGERY SEE PUBLICATION ON FDA RESULTS ON CHARITE DISC BACKGROUND What is a Disc? The spine is a column that is made of up bones, discs and ligaments. The blocks of bone (or vertebrae) provide the anterior support and structure of the spine. The discs are in between the bones and act like a “shock absorber” between the vertebrae. The discs also contribute to the flexibility and mobility of the spinal column. The discs are made up of two parts: the inner portion of the disc is a jelly-like material and is called the nucleus pulposus and the outer part, called the anulus fibrosus of the disc, is stronger and more fibrous. The anulus fibrosus surrounds and supports the inner jelly material. The anulus is rich in nerve fibres, especially the back portion, and may play a role in the production of discogenic back pain. Disc material is mainly composed of water and other proteins. As a normal part of aging, the water content gradually reduces. This can cause the disc to flatten out and even develop tears or cracks throughout the annulus fibrosus. These discs are often referred to as “degenerative” discs and may or may not cause pain. In the case of a degenerative disc, the inner jelly material (the nucleus pulposus) can bulge out and press up against the anulus fibrosus. This can stimulate the pain receptors causing pain to occur. The cracks or tears that develop within the annulus fibrosus can also become a source of pain. Finally, the inner nucleus can also come out through the cracks in the annulus and compress nerves or spinal cord, a condition that may cause weakness, pain, pins and needles or numbness, and may require surgery.

73. Lumbar Disc Disease (Herniated Disc) Detailed information on lumbar disc disease, including cause, symptom, diagnosis, and treatment. http://www.healthsystem.virginia.edu/uvahealth/adult_neuro/hdisc.cfm

[ Skip Navigation ] Health System Home For Health Answers Healthcare Professionals ... Advanced Search Health System Search Search for Information People UVa Home Health System News Health System Events (all) Health System Publications ... Making a Gift Topics All About Cancer Blood Disorders Bone Disorders Breast Health Cancer Cardiovascular Disease Dermatology Diabetes Digestive Disorders Endocrinology Environmental Medicine Eye Care Glossary Gynecological Health Infectious Diseases Kidney Disease Men's Health Mental Health Nervous System Disorders Non-Trauma Emergency Oral Health Orthopaedics Otolaryngology Pathology Pediatrics, General Health Prostate Health Radiology Respiratory Disorders Skin Cancer Surgical Care Urology Women's Health UVa Health Topics A to Z FIND A DOCTOR Brain Cancer: Medical Oncology Brain Tumors Epilepsy ... WHY CHOOSE UVA Search This Site Lumbar Disc Disease (Herniated Disc) Anatomy of the lumbar spine: The vertebral column, also called the backbone, is made up of 33 vertebrae that are separated by spongy disks and classified into four distinct areas. The cervical area consists of seven bony parts in the neck; the thoracic spine consists of 12 bony parts in the back area; the lumbar spine consists of five bony segments in the lower back area; five sacral bones (fused into one bone, the sacrum); and four coccygeal bones (fused into one bone, the coccyx). Lumbar disc disease occurs in the lumbar area of the spine. The lumbar area of the spine (and other areas of the spine) is made up of two parts, including the following:

74. Clinical Evidence Musculoskeletal Disorders Herniated Disc Herniated lumbar disc is a displacement of disc material (nucleus pulposus The prevalence of symptomatic herniated lumbar disc is about 1–3% in Finland http://www.clinicalevidence.com/ceweb/conditions/msd/1118/1118_background.jsp

75. Dr.Schiffer - Lumbar Endoscopic Discectomy For Herniated Disc, Lower Back Pain R Dr.Schiffer performs lumbar endoscopic discectomy and thermal annuloplasty for relief of lower back pain, leg pain and sciatica. http://www.drschiffer.com/procedures_led.html

Cervical Endoscopic Discectomy Anterior Cervical Discectomy Anterior Cervical Fusion Lumbar Endoscopic Discectomy and Thermal Annuloplasty Microdiscectomy Thermal Annuloplasty CED ACD ACF LED/IDET MD IDET Glossary Testimonials ... FAQ tel:510.792.2911 fax:510.794.7924 Toll Free:877.463.5942 LED/IDET Lumbar Endoscopic Discectomy and Thermal Annuloplasty for relief of lower back pain, leg pain, and sciatica What are Lumbar Discs? Lumbar discs are the structures which serve as shock absorbers between the vertebrae of the spinal column. The center of the disc, called the nucleus, is soft and springy and accepts the shock of standing, walking, running, etc. The outer ring of the disc, called the annulus, provides structure and strength to the disc. The annulus is comprised of a complex series of interwoven layers of fibrous tissues which hold the nucleus in place. What is a Herniated Disc Herniated discs are often called a "slipped disk". This term was derived from the action of the nuclear tissue when it is forced from the center of the disc. The disc itself does not slip. However, the nuclear tissue located in the center of the disc can be placed under so much pressure that it can cause the annulus to herniate or rupture. When the disc has herniated or ruptured, it may create pressure against one or more of the spinal nerves which can cause pain, weakness or numbness in the lower back, leg or foot (sciatica). Other common names for a herniated disc are "protruded disk" and "

76. Kerlan-Jobe Orthopaedic Clinic Injury Lumbar Disc Herniation The herniation or rupture of a lumbar disc occurs when the center or soft The severity and level of the lumbar disc herniation determines the type of http://www.kerlanjobe.com/index.php?practiceId=1052&lib=Injury&dir=categories&ca

77. Rural Nurse Organization Clinic Digital Library lumbar Disc Disease (Keyword search) List of documents. Miscellaneous lumbar Disc Disease Clinical Resources. HealthWeb Homepage http://ruralnurseorganization-dl.slis.ua.edu/clinical/orthopedics/back/lumbar-di

Clinical Resources by Topic: Orthopedics Lumbar Disc Disease Clinical Resources Emergency Pediatrics Radiology Physical/Rehabilitation ... Miscellaneous Resources See also: Musculoskeletal Clinical Procedure Resources General Orthopedics Clinical Resources Lumbar Disc Disease Patient/Family Resources Wheeless' Textbook of Orthopaedics: Table of contents Spine Index: List of documents Physical Exam of the Spine: Access document Low Back Pain in the Adult: Access document Intervertebral Discs: Access document The Merck Manual 17th Ed.-1999: Table of contents Chapter 49: Approach to the Patient with Joint Disease: Table of contents General: Access document Introduction: Access document Physical Examination: Access document Introduction: Access document Vertebral Column: Access document Diagnosis: Access document Differentiating Inflammatory and Noninflammatory Joint Disease: Access document Chapter 62: Common Sports Injuries: Table of contents General: Access document Lumbar Strain: Access document Family Practice Handbook 4th Ed.-2001: Table of contents Chapter 16: Orthopedics: Table of contents Low Back Pain: Access document Medicine, Ob/Gyn, Psychiatry, and Surgery (eMedicine):

78. Herniated Disc lumbar disc disease occurs in the lumbar area of the spine. What is lumbar disc disease (herniated disc, ruptured disc or bulging disc)? http://medicalcenter.osu.edu/patientcare/healthinformation/diseasesandconditions

Skip Navigation home about us referring ... Herniated Disc Herniated Disc Lumbar Disc Disease (Herniated Disc) Click Image to Enlarge Anatomy of the lumbar spine: The vertebral column, also called the backbone, is made up of 33 vertebrae that are separated by spongy disks and classified into four distinct areas. The cervical area consists of seven bony parts in the neck; the thoracic spine consists of 12 bony parts in the back area; the lumbar spine consists of five bony segments in the lower back area; five sacral bones (fused into one bone, the sacrum); and four coccygeal bones (fused into one bone, the coccyx). Lumbar disc disease occurs in the lumbar area of the spine. The lumbar area of the spine (and other areas of the spine) is made up of two parts, including the following: vertebral bodies - the parts that are made of bone. intervertebral discs - also known as the discs; the discs are located between the bony parts of the spine and act as "shock absorbers" for the spine. The vertebral bodies are numbered from 1 to 5 in the lumbar spine and the discs are located between two of the vertebral bodies and are numbered accordingly (such as a disc at L2-3, or between the lumbar discs numbered 2 and 3). The intervertebral disc is composed of two parts, including the following:

79. NEJM -- Sign In Book Review from The New England Journal of Medicine lumbar Disc Herniation. http://content.nejm.org/cgi/content/full/347/21/1728-a

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80. Post-accident Lumbar Disc Herniation - Medical Illustration This custom medical exhibit reveals an actual print of a patients postaccident MRI mounted beside a matching interpretive illustration. http://catalog.nucleusinc.com/generateexhibit.php?ID=826&ExhibitKeywordsRaw=&TL=

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