Unusual cause of acute low-back pain: sudden annulus fibrosus rupture
Low-back pain is a common problem in neurosurgery practice, and an algorithm has been developed for assessing these cases. However, one subgroup of these patients shares several clinical features and these individuals are not easy to categorize and diagnose. We present our observations for 8 of thes...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Open Medical Publishing
2012-06-01
|
| Series: | Orthopedic Reviews |
| Subjects: | |
| Online Access: | http://www.pagepress.org/journals/index.php/or/article/view/4248 |
| _version_ | 1829509733606752256 |
|---|---|
| author | Ali Fahir Ozer Tunc Oktenoglu Mehdi Sasani Tuncay Kaner Omur Ercelen Nazan Canbulat |
| author_facet | Ali Fahir Ozer Tunc Oktenoglu Mehdi Sasani Tuncay Kaner Omur Ercelen Nazan Canbulat |
| author_sort | Ali Fahir Ozer |
| collection | DOAJ |
| description | Low-back pain is a common problem in neurosurgery practice, and an algorithm has been developed for assessing these cases. However, one subgroup of these patients shares several clinical features and these individuals are not easy to categorize and diagnose. We present our observations for 8 of these patients, individuals with low-back pain caused by atypical annulus fibrosus rupture (AAR). The aim of this study is to show the consequences of overlooked annular tears on acute onset of low back pain. Eight patients with acute-onset severe low-back pain were admitted. Physical examinations were normal and each individual was examined neurologically and assessed with neuroradiologic studies [plain x-rays, magnetic resonance imaging (MRI), discography and computed tomography (CT) discography]. AAR was ultimately diagnosed with provocative discography. In all cases, MRI showed a healthy disc or mild degeneration, whereas discography and CT discography demonstrated disc disease. Anterior interbody cage implantation was performed in 3 of the 8 cases and posterior dynamic stabilization was carried out in 3 cases. The other 2 individuals refused surgery, and we were informed that one of them developed disc herniation at the affected level 1 year after our diagnosis. Clinical and radiological outcomes were evaluated. In cases where AAR is suspected, MRI, discography, and CT discography should be performed in addition to routine neuroradiologic studies. |
| first_indexed | 2024-12-16T11:52:04Z |
| format | Article |
| id | doaj.art-abf892efd014435c8ce078547e5dd2fe |
| institution | Directory Open Access Journal |
| issn | 2035-8237 2035-8164 |
| language | English |
| last_indexed | 2024-12-16T11:52:04Z |
| publishDate | 2012-06-01 |
| publisher | Open Medical Publishing |
| record_format | Article |
| series | Orthopedic Reviews |
| spelling | doaj.art-abf892efd014435c8ce078547e5dd2fe2022-12-21T22:32:41ZengOpen Medical PublishingOrthopedic Reviews2035-82372035-81642012-06-0142e22e2210.4081/or.2012.e222170Unusual cause of acute low-back pain: sudden annulus fibrosus ruptureAli Fahir Ozer0Tunc Oktenoglu1Mehdi Sasani2Tuncay Kaner3Omur Ercelen4Nazan Canbulat5Neurosurgery Department, Koc University School of MedicineNeurosurgery Department, American HospitalNeurosurgery Department, American HospitalNeurosurgery Department, Istanbul Medeniyet University School of MedicineAnesthesiology and Pain Department, American HospitalPhysical Treatment and Rehabilitation Department, American HospitalLow-back pain is a common problem in neurosurgery practice, and an algorithm has been developed for assessing these cases. However, one subgroup of these patients shares several clinical features and these individuals are not easy to categorize and diagnose. We present our observations for 8 of these patients, individuals with low-back pain caused by atypical annulus fibrosus rupture (AAR). The aim of this study is to show the consequences of overlooked annular tears on acute onset of low back pain. Eight patients with acute-onset severe low-back pain were admitted. Physical examinations were normal and each individual was examined neurologically and assessed with neuroradiologic studies [plain x-rays, magnetic resonance imaging (MRI), discography and computed tomography (CT) discography]. AAR was ultimately diagnosed with provocative discography. In all cases, MRI showed a healthy disc or mild degeneration, whereas discography and CT discography demonstrated disc disease. Anterior interbody cage implantation was performed in 3 of the 8 cases and posterior dynamic stabilization was carried out in 3 cases. The other 2 individuals refused surgery, and we were informed that one of them developed disc herniation at the affected level 1 year after our diagnosis. Clinical and radiological outcomes were evaluated. In cases where AAR is suspected, MRI, discography, and CT discography should be performed in addition to routine neuroradiologic studies.http://www.pagepress.org/journals/index.php/or/article/view/4248atypical annulus fibrosus rupture, CT discography, low-back pain |
| spellingShingle | Ali Fahir Ozer Tunc Oktenoglu Mehdi Sasani Tuncay Kaner Omur Ercelen Nazan Canbulat Unusual cause of acute low-back pain: sudden annulus fibrosus rupture Orthopedic Reviews atypical annulus fibrosus rupture, CT discography, low-back pain |
| title | Unusual cause of acute low-back pain: sudden annulus fibrosus rupture |
| title_full | Unusual cause of acute low-back pain: sudden annulus fibrosus rupture |
| title_fullStr | Unusual cause of acute low-back pain: sudden annulus fibrosus rupture |
| title_full_unstemmed | Unusual cause of acute low-back pain: sudden annulus fibrosus rupture |
| title_short | Unusual cause of acute low-back pain: sudden annulus fibrosus rupture |
| title_sort | unusual cause of acute low back pain sudden annulus fibrosus rupture |
| topic | atypical annulus fibrosus rupture, CT discography, low-back pain |
| url | http://www.pagepress.org/journals/index.php/or/article/view/4248 |
| work_keys_str_mv | AT alifahirozer unusualcauseofacutelowbackpainsuddenannulusfibrosusrupture AT tuncoktenoglu unusualcauseofacutelowbackpainsuddenannulusfibrosusrupture AT mehdisasani unusualcauseofacutelowbackpainsuddenannulusfibrosusrupture AT tuncaykaner unusualcauseofacutelowbackpainsuddenannulusfibrosusrupture AT omurercelen unusualcauseofacutelowbackpainsuddenannulusfibrosusrupture AT nazancanbulat unusualcauseofacutelowbackpainsuddenannulusfibrosusrupture |