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         Herniated Lumbar Disk:     more detail

81. Levine, Overby, Hollis & Eisenberg
caused by a pinched nerve from a herniated lumbar disc are The herniated portion ofthe disc is removed as well helps release the pressure when the disk bulges
http://www.neuromds.com/lohe-procedures.htm
About Our Procedures
Procedures
Meningioma

Schwannoma

Acoustic Neuroma

Craniotomy
...
Endovascular treatment

Drs. Levine, Overby, Hollis and Eisenberg are all highly trained board certified neurosurgeons. We currently use the latest technology and techniques in order to provide the safest neurosurgical care for our patients. Below are some of the procedures our practice performs. For further questions, please contact one of our offices. Skull and Brain Surgery Meningioma Meningiomas are tumors that generally arise between the skull and the brain and compress the brain as they grow. The treatments available include surgical removal, stereotactic radiation therapy, or close observation with serial MRI scans. Surgical removal is the only treatment that offers a potential for complete cure. A detailed history, exam and consultation is necessary before your neurosurgeon can determine what the best treatment plan is. Schwannoma Each of the nerves in the body is covered by a layer of cells which insulate the nerve called schwann cells. Tumors which arise from these cells are called schwannomas and since every nerve has this schwann cell covering, schwannomas can occur anywhere.

82. Vax-D Research
is possible to lower pressure in the nucleus pulposus of herniated lumbar discs to 322327,1978; Hirsch C. Nachemson A Lyle reliability of lumbar disk surgery
http://www.vaxdtexas.com/research7.shtml

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VAX-D RESEARCH
TABLE 1
Effect of lumbar traction on intradiscal pressure* Case
No. Sex,
Age Index
Monitored
M, 23 traction tension, lbs
intradiscal pressure, mm Hg
F, 41 traction tension, lbs
intradiscal pressure, mm Hg
M, 34 traction tension, lbs intradiscal pressure, mm Hg *See Fig. 2 for graphs of data points. Measurements in the first two patients could not be translated accurately and are omitted (see text). Fig. 2 Graphs showing the intradiscal pressures recorded in the L4-5 nucleus pulposus of three patients (Case 3, upper ; Case 4, center ; and Case 5, lower ) with a herniated disc at this level. Pressure is plotted against distraction tension consistent with the range of tension recommended as the therapeutic protocol for the equipment used in this study. The biological transducers employed in this study are primarily designed to measure pressure changes in the positive range. Following each procedure the pressure monitor and the disposable pressure transducer used for each patient were individually calibrated and a correction curve was plotted showing the transducer readings versus actual pressures, to correct for the nonlinearity of the instrumentation in the range of negative pressures achieved. A pneumatic calibration analyzer with an accuracy of 2% was used for this purpose.

83. BACK INJURIES
from strains, sprains, subluxations, slip disks, herniated disks, ruptured disk problems(3 ), with great sensitivity of a Pain In lumbar region and sacrum, esp
http://www.simillimum.com/FirstAid/TheFirstResponder/FirstAidin/BackInjuries.htm
THE HOMOEOPATHIC FIRST RESPONDER Back to Homoeopathic First Responder
BACK INJURIES
Materia Medica AESC (1), Disk problems (3). Weakness, weariness and lameness in the small of the back, sore and tried mornings when awakening. constant dull backache, walking almost impossible, scarcely able to stoop or to rise after sitting, esp. across hips and sacrum. AGARICUS. Disk problems (3 ), with great sensitivity of a single vertebrae. Pain In lumbar region and sacrum, esp. during exertion in daytime and while sitting. Crick in the back. Coldness of glutei. ARNICA (3). Useful immediately after the injury to remove shock and trauma. Concussion to the spine. BELLIS. (2) Useful for shock and trauma to deep tissues and organs, especially of the pelvis conco. to back injuries. Internal injuries, sometimes called the "internal Arnica". Lameness as if sprained. Much muscular soreness. Sore bruised feeling of the pelvic region. BERBERIS (2) Disk problems . Pain form back to stomach or vice versa, going around abdomen towards the bladder. BRYONIA (3*). Disk problems. Drawing and stiffness of cervical muscles, esp. right side. Shooting stitches in back through to chest

84. Glossary Of Pain Management
herniated Disc The nucleus of a lumbar disc oozes out of the center of the disk,pressing against a nerve causing severe pain, after the annulus of the disk
http://www.garyflegal.com/glossary.htm
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Glossary* of Terms Related To Pain and Treatment Aching Back Acupuncture Addiction Alexander Technique ... Intramuscular (IM) Intrathecal (IC) Intravenous (IV) Kinesiology Kyphosis Local anesthetics Lordosis ... Yoga Therapy Aching Back - Painful back usually caused by pulled, strained or torn muscles. Acupuncture - Vital energy is balanced throughout the body by inserting fine needles on specific meridian points for the purpose of relieving tension, stress, and pain. Highly useful in the treatment and relief of back pain. Addiction - Psychological, emotional, or physical dependence on the effects of a drug. Alexander Technique - A form of movement therapy where practitioners instruct on proper posture, coordination, and muscle balance. Efficient methods of sitting, standing, walking, and proper posture are taught. Generally effective in back pain relief as it teaches proper posture. Alternative Medicine - The use of various non-drug, non-surgical related therapies. Using natural means of treatment.

85. Pain And Headache Center --- HealthandAge
abnormalities on MRI a herniated disk, a bulging disk, a degenerative disk, spinalstenosis major anatomical components of the lumbar spine requires
http://www.healthandage.com/PHome/gm=0!gc=31!gid2=1244
English site German site March 30, 2003
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Pain and Headache Low Back Pain - Today Low Back Pain - Today Summarized by Guy Heynen, MD
August 10, 2001 Natural course The vast majority of low back pain cases presenting to the general practitioner have a benign cause, evolution and outcome. Up to 70% of them are classified as nonspecific strains or sprains, and remission occurs within 2 weeks in 90% of those presenting with acute episodes. Low back pain tends to become chronic or recurrent in some patients, associated with depressive mood or symptoms, but even the majority of such cases have a good functional outcome. It's important, therefore, that patients are fully informed on the probable cause at the first acute episode, and reminded of it later, if and when recurrences occur. The pain of a herniated disk shows slower improvement than that of a sprain; about 10% require surgery for persistent pain lasting 6 weeks or more. Objective evidence for non-surgical regression of herniated disk within 6 months in two thirds of cases has been established by sensitive imaging technique. In contrast, spinal stenosis remains stable in 70% of cases, but progression is reported in 15%, and 15% show regression. Return to work after an acute episode is influenced by both socio-economic and clinical factors, and will be the subject of another article. Low back pain is rarely disabling.

86. Chirurgie De La Colonne Vertébrale : Liens
Translate this page Especially about herniated disc, herniated disk, spine, laminectomy, back, leg,knee, neck pain, lumbar, pinched nerve, sciatica, neurosurgery, arthroscopic
http://www.chirurgie-vertebrale.com/Liens/liens.html
Cette page présente des liens vers des ressources web relatives à la chirurgie vertébrale et, de façon plus générale, à la médecine et à la santé. Clinique de la Sauvegarde :
    La Clinique de la Sauvegarde est un établissement de santé médico-chirurgical mettant à votre disposition un plateau technique unique, un réseau de praticiens de toutes spécialités travaillant ensemble pour le traitement médical et chirurgical des pathologies de la colonne vertébrale, mais également d'un grand nombre d'autres pathologies.
    http://www.clinique-sauvegarde.fr/
La chirurgie micro-endoscopique de la hernie discale :

87. JMRM Journal Abstracts, Volume 18 Number 2
MR Guided Percutaneous Laser lumbar disk Hernia Ablation. Methods As subjects, 36patients with lumbar disc herniation was used to puncture the herniated discs
http://wwwsoc.nii.ac.jp/jmrm/abstract/JMRM18-2.html
Abstracts of Vol.18 No.2
HEADLINE
Signal Changes in Vertebral Bone Marrow in Cirrhotic Patients Evaluatedwith STIR Sequence Hiroyuki UEDA. p57-65. MR Measurement of Coronary Arterial Blood Flow Velocity : Evaluation of Age, Stenosis and Drugs as Factors Affecting Coronary Blood Flow Yoshiaki TAOKA et al. p66-73. Influence of Metallic Coronary Arterial Stents on MR Coronary Angiography Hirokazu SHIRAISHI et al. p67-80. Whole Liver Dynamic CT and Dynamic MR Imaging of Small Hepatocellular Carcinoma: A Comparative Study of Tumor Detection and Morphologic Features Based on Histologic Differentiation Yan ZHANG. p81-91. ... Two Cases of Ameloblastoma Presenting as Maxillary Sinus Masses Hiroya OJIRI. p114-119.
Signal Changes in Vertebral Bone Marrow in Cirrhotic Patients Evaluatedwith STIR Sequence
MR Measurement of Coronary Arterial Blood Flow Velocity :
Evaluation of Age, Stenosis and Drugs as Factors Affecting Coronary Blood Flow
Influence of Metallic Coronary Arterial Stents on MR Coronary Angiography
Whole Liver Dynamic CT and Dynamic MR Imaging of Small Hepatocellular Carcinoma:
A Comparative Study of Tumor Detection and Morphologic Features Based on Histologic Differentiation
Yan ZHANG Department of Radiology, Kurume University School of Medicine 67 Asahimachi, Kurume-shi, Fukuoka 830 For the purpose of evaluating the detection of small hepatocellular carcinoma (HCC) and morphologic features thereof using dynamic CT (D-CT) and dynamic MRI (D-MRI) , and for evaluating the same with respect to histologic differentiation in particular, 50 patients with 70 histologically verified sites of nodular HCC less than 20 mm in diameter were examined as subjects. Results were compared utilizing the x^2 test. The detection rate of small sites of HCC with early-phase D-MRI (56%) was slightly higher than that using early-phase D-CT (49%) , whereas detection rate using delayed-phase D-CT (59%) was slightly higher than that using delayed-phase D-MRI (53%). The capsular pattern of small HCC nodules (diameter 10 mm or greater but less than 20 mm) was better visualized using D-MRI than D-CT (visualized in 51% and 27%, respectively ; p

88. Back1.com - Back Pain
This condition is called a ruptured, slipped, or herniated disk. Another name forthis condition is a slipped disk. and legs if it is a lumbar spine injury, or
http://www.back1.com/care/Condition20.cfm/2
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Back Pain
Quick Reference
Reviewed by Dr. Clement J. Cheng
Back pain from an unknown cause is the second leading cause of absence from work in the United States, second only to the common cold. It is the leading cause of disability in people aged 18 to 45. Four out of five adults will experience significant lower back pain sometime during their life.
Detailed Description
The back is divided into five sections. The coccyx and sacrum are immobile sections of fused vertebrae; they are located below your waistline into the buttocks. The lumbar spine contains five vertebrae that run from the top of the buttocks to the lower chest; the thoracic spine has 12 vertebrae, which span from the lumbar spine to the shoulders; and the cervical spine, 7 vertebrae, which are found in the neck. The thoracic, cervical and lumbar spines give you the flexibility to bend, stretch, lift, and twist. The cervical and lumbar spines are the most flexible, and therefore, the most injury prone.
Back pain, while easy to diagnose, is often hard to pinpoint. There are so many possible causes, and so many different sensations of pain associated with it that often takes some time to diagnose the specific cause of your pain. Lower back pain is the most common type of back pain, and it can be caused by anything from injury to aging.

89. LOW BACK PAIN SYNDROME
lumbar paraspinal muscle spasm frequently is noted with local radiculitis, whichis due to many causes, including herniated lumbar intervertebral disk.
http://www.geocities.com/altmedd/pain/low_back_pain_syndrome.htm
LOW BACK PAIN SYNDROME
Pain guide Low back pain is one of the most ubiquitous of ailments. About 80% of people are so afflicted at some time during their lives, and of these, 1-2% become chronically impaired. Low back pain may be associated with a variety of causes. These patients are subjected to a large number of diagnostic procedures with ambiguous or unrevealing results. This reflects inadequate clinical evaluation and a failure to utilize information obtained from properly conducted history and physical examination.
Clinical Findings
A history of the patient's illness should include occupation, injuries, onset of symptoms, pattern of pain and relationship to physical activity, aggravating and relieving factors, emotional status, loss of time from work, and possible litigation. Inspection and palpation of the painful area are important. Since pain from nerve roots or nerves is commonly referred toward the periphery, the physician should explore the entire nerve lengths leading from the painful area and should note the presence of any masses or tenderness and, where possible. the size and consistency of nerves. Muscle spasm and tenderness to percussion and deep pressure may give evidence suggesting radicular irritation, particularly when associated with local deformity or restriction of spinal motion. Lumbar paraspinal muscle spasm frequently is noted with local radiculitis, which is due to many causes, including herniated lumbar intervertebral disk.

90. NEJM -- Sign In
disk protrusion when patients were imaged by MRI while the lumbar spine was compressedin an allwood compression frame.3 A recent treatment for herniated-disk
http://content.nejm.org/cgi/content/full/337/19/1396

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91. NEUROSURGERY://ON-CALL® Herniated Disc
Feel free to consult your physical therapist for more specific recommendations regardingpostoperative or postherniated disc lumbar spine reconditioning and
http://www.neurosurgery.org/health/patient/answers.asp?DisorderID=37

92. What Is A Herniated Disc, Pinched Nerve, Bulging Disc, Etc...?
Provides indepth descriptions of spinal disc disorders, such as a herniated disc, pinched nerve, Category Health Conditions and Diseases Ruptured disk...... abnormalities include Pinched nerve; Sciatica; herniated disc (orherniated disk); Bulging disc, ruptured disc, or slipped disc; Disc
http://www.spine-health.com/topics/cd/d_difference/diff01.html
Introduction Common causes Conservative care Surgery ... Anatomy
Sign up for our free educational newsletter. Animation of: Lumbar disc herniation Related information: Interactive view of spinal anatomy Vertebral disc anatomy Multi-specialty case on lumbar disc herniation Multi-specialty case on sciatica ... MRI scan of the lumbar spine
There are many different terms to describe spinal disc pathology, and all are used differently by different healthcare practitioners. Some examples of terms used to describe spinal disc abnormalities include:
  • Pinched nerve
  • Sciatica
  • Herniated disc (or herniated disk)
  • Bulging disc, ruptured disc, or slipped disc
  • Disc protrusion
  • Disc degeneration (or degenerative disc disease)
  • Disc disease
There is no agreement in the medical field as to the precise definition of any of these terms. Often the patient hears his or her diagnosis referred to in different terms by different practitioners and is left wondering if there is any consensus on what is wrong.

93. Hernia (Herniated, Herniation) Articles, Support Groups, And Resources
Liver Diseases Forum); ALS vs Cervical Spondyliosis § lumbar herniateddisk (Neurology and Neurosurgery Forum); back pain and herniated
http://www.medhelp.org/HealthTopics/Hernia.html
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94. Discussion Group Of Low Back Pain
mark 10 Mar 2003 lumbar fusion Pete 05 Mar 2003 Sharp Racerchser@aol.com 12 Mar 2003Disk bulge diognosed and numbness dan 14 Mar 2003 herniated disc recovery
http://www.lowback-pain.com/discussiongroup/disc1_tocf.htm
HOME PAGE
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CONTENTS
do exercises help low back pain? robert h 29 May 2002
Re: do exercises help low back pain? Jan 06 Jul 2002
Re: do exercises help low back pain? Dr. Bryan Brodeur 15 Aug 2002 Re: do exercises help low back pain? mary@wizwire.com 27 Feb 2003
Re: do exercises help low back pain? nc 03 Mar 2003
does anyone have any personal recommendations on weight loss? Bruce Simpson 03 Jun 2002
Re: does anyone have any personal recommendations on weight loss? Buddy 12 Jun 2002 Re: does anyone have any personal recommendations on weight loss? Frank w 06 Aug 2002 Re: does anyone have any personal recommendations on weight loss? Laz 22 Oct 2002 Re: does anyone have any personal recommendations on weight loss? fitnesstrainer@healingwell.com 10 Nov 2002 Re: does anyone have any personal recommendations on weight loss? 12 Feb 2003 Re: does anyone have any personal recommendations on weight loss? rawehage@insightbb.com 10 Mar 2003
what is better? treadmill, elliptical or swimming? george mack 15 Jun 2002
Re: what is better? treadmill, elliptical or swimming?

95. CyberSpace Search!
SEARCH THE WEB. Results 1 through 10 of 12 for herniated disk.
http://www.cyberspace.com/cgi-bin/cs_search.cgi?Terms=herniated disk

96. James V. Gainer, Jr., M.D.
8, pp 974977, 1974. Gainer, JV, Jr., and Nugent, GR The herniated LumbarDisk, American Family Physician, Vol 10, No. 3, pp 127131, 1974.
http://www.neurosurgery.ufl.edu/FacultyPage/Gainer.html
James V. Gainer, Jr., M.D Clinical Professor
James V. Gainer, Jr. M.D. received his B.S. degree from West Virginia University, Morgantown, West Virginia. In 1959 he received his medical degree from Jefferson Medical College in Philadelphia, PA. Dr. Gainer completed his medical internship at the US Naval Hospital in Philadelphia in 1960 and his neurosurgical residency at West Virginia School of Medicine in Morgantown in 1975. Dr. Gainer is a graduate of the US Naval School of Aviation Medicine and has served as Naval Flight Surgeon in Pensacola, FL. (1961-64). He retired with the rank of Captain, MC, USNR in 1990. Dr. Gainer has over 3 decades of medical experience in private practices in West Virginia and Gainesville, FL. His academic practice started with his appointment in 1999 as Clinical Professor, Department of Neurosurgery, University of Florida. Dr. Gainer is a Diplomat of the American Board of Neurological Surgery, a Fellow of the American College of Surgeons, and has served as Chief of Surgery at Alachua General Hospital, Gainesville, FL. Special Interests: Spinal Neurosurgery, Peripheral Nerve Surgery, Rehabilitation

97. Back Pain Patient Outcomes Assessment Team (BOAT)
Spine, 18(11), 1463–1470. Deyo, RA, Loeser, JD, and Bigos, SJ (1990). Herniatedlumbar intervertebral disk. Annals of Internal Medicine, 112(8), 598–603.
http://www.ahcpr.gov/clinic/medtep/backpain.htm
Back Pain Patient Outcomes Assessment Team (BOAT)
Principal Investigator: Richard A. Deyo, M.D., M.P.H., University of Washington School of Medicine, Seattle. Grant Number: HS 06344. Project Period: September 1989 to September 1994.

The back pain PORT, supported by AHCPR, analyzes back surgery practice variations and examines the relative effectiveness of alternate ways of diagnosing and treating low back pain.
Back Pain PORT Contents (Summer 1994)
Introduction Findings
Dissemination
Implications ... Contents The problem of back pain is widespread (affecting up to 8 of every 10 adults some time in life), causes suffering and stress, and is the second leading reason why Americans see physicians. Back pain also affects the Nation's economy. According to some estimates, back pain costs as much as $50 billion a year for medical care, workers compensation payments, and time lost from work. However, the true economic impact of back pain is more extensive, because these estimates include neither unrealized earnings due to physical limitations caused by back pain nor employer productivity losses. To determine what treatment strategies work best and for whom, the back pain PORT is examining the relative value of diagnostic tests such as myelography, computed tomography, magnetic resonance imaging, and thermography. The PORT is also examining surgical procedures (such as fusion, laminectomy, and discectomy) and nonsurgical interventions (such as traction and therapeutic injections).

98. AAPM&R - Physical Medicine And Rehabilitation Article
N Engl J Med. 1986;31510641070. Deyo RA, Loesser JD, Bigos SJ. Herniatedlumbar intervertebral disk. Ann Intern Med. 1990;112598-603. Saal JA.
http://www.aapmr.org/medstu/article.htm

What is a Physiatrist?
Legislative, Business and Clinical Practice Issues Annual Assembly Medical Education ... Medical Students
Physical Medicine and Rehabilitation
Reprinted from JAMA (Contempo 1993), July 14, 1993—Vol 270, No.2 Kristi L. Kirschner, MD
Henry B. Betts, MD
Rehabilitation Institute of Chicago (III) Physiatry has continued to evolve with changing patterns of illness and disability. The Institute of Medicine estimates that 35 million Americans (approximately one in seven) have disabling conditions. More than 9 million are unable to work, study, or live independently. The average American will live almost 13 years with some sort of limitation. A 1988 National Health Interview Study showed that the incidence of disability increases dramatically with age. About 5% of those under the age of 18 years have some degree of activity limitation, increasing to almost 40% in those 65 and over. Chronic illnesses, arthritis, strokes, trauma, and pain syndromes account for a significant proportion of functional limitations. As specialists in the pathogenesis, prevention, and remediation of disability, physiatrists are in a position to assist a variety of practitioners in maximizing function and quality of life. In particular, there have been exciting advances in the treatment of low back pain (LBP), sexuality and fertility in spinal cord injury (SCI), and the role of physiatrists in treating patients with terminal conditions, including the acquired immunodeficiency syndrome (AIDS).

99. References
29. Humphreys SC, Eck JC Clinical evaluation and treatment options for herniatedlumbar disk. Am Fam Physician 1999;59(3)575582, 587-588. 30.
http://www.familypractice.com/references/ABFPGuides/Back/reference.htm
REFERENCES Facts About Family Practice. American Academy of Family Physicians, 1996, p 54. Sci Am Curr Opin Rheumatol Low Back Pain. AAFP Home Study Self-Assessment monograph series, 1994, no 185, p 11. Low Back Pain: Medical Diagnosis and Comprehensive Management. WB Saunders Co, 1994. Functional Restoration for Spinal Disorders: The Sports Medicine Approach. J Fla Med Assoc Phys Med Rehabil Clin North Am Surg Rounds Orthop Annu Rev Public Health Acute Low Back Problems in Adults. Clinical Practice Guideline, Quick Reference Guide no 14. USDHHS, AHCPR pub no 95-0643, 1994. JAMA Phys Med Rehabil Clin N Am Clin Symp J Gen Intern Med Mayo Clin Proc Phys Med Rehabil Clin N Am Physical Examination of the Spine and Extremities. Appleton-Century-Crofts, 1976, pp 237-263. Acta Orthop Scan Suppl Spine J Occup Med A Guide to Physical Examination and History Taking , ed 5. JB Lippincott Co, 1991, pp 487-490. Peripheral Neuropathy , ed 3. WB Saunders Co, 1992, chap 45.

100. RI Medical Advisory Board - Protocols
Protocols and Standards of Treatment. The Board has promulgated thirtyseven(37) protocols and standards of treatment since its inception.
http://www.courts.state.ri.us/workers/medical/protocols.htm
var MenuLinkedBy='AllWebMenus [2]', awmBN='456'; awmAltUrl=''; Workers Compensation
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Administrative Offices Annual Report ... Rules of Procedure
Protocols and Standards of Treatment
The Board has promulgated thirty-seven (37) protocols and standards of treatment since its inception. The protocols were not designed as "cookbooks" of care, rather they outline options of appropriate methods and types of intervention from which physicians and other providers are to choose. Although primarily geared toward the entry level physician, i.e., the first treating physician, these protocols offer important information for all physicians and health care providers. Upon drafting and review by the Board, each protocol is put in final form. It is then brought to public hearing for full discussion, final revisions and promulgation. Current List of Protocols All Protocols
Title Page, Preface, Table of Contents
Carpal Tunnel Syndrome
Cervical Musculoligamentous Injury (Sprain/Strain)
...
Occupational Hearing Impairment Treatment Protocol

To obtain a copy of the protocols: Send $25.00 check made payable to: Administrator, Workers Compensation Court

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