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Spinal disc protrusion visible in MRI [1] A disc protrusion is a medical condition that can occur in some vertebrates, including humans, in which the outermost layers of the anulus fibrosus of the intervertebral discs of the spine are intact but bulge when one or more of the discs are under pressure.
CT scan image of large herniated disc in the lumbar spine. Removal of a disc at one level can lead to disc herniation at a different level at a later time. Even the most complete surgical excision of the disc still leaves 30–40% of the disc, which cannot be safely removed. This retained disc can re-herniate sometime after surgery.
Disc herniation is normally a further development of a previously existing disc protrusion, in which the outermost layers of the annulus fibrosus are still intact, but can bulge when the disc is under pressure. In contrast to a herniation, none of the central portion escapes beyond the outer layers.
Modic changes is a descriptive term used by radiologists in MRI evaluations. Conventional treatment including physiotherapy, chiropractic, acupuncture, and exercise for back pain, are not effective in treating Modic changes. Conversely, long term antibiotic treatment has been shown to be an effective treatment if done effectively.
Schmorl's nodes are fairly common, especially with minor degeneration of the aging spine, but they are also seen in younger spines. Schmorl's nodes often cause no symptoms, but may simply reflect that "wear and tear" of the spine has occurred over time; they may also reflect that bone strength was at one time somewhat compromised, perhaps due to a vitamin D deficiency although this has yet to ...
Postoperative radiation is delivered within 2–3 weeks of surgical decompression. Emergency radiation therapy (usually 20 grays in 5 fractions, 30 grays in 10 fractions or 8 grays in 1 fraction) is the mainstay of treatment for malignant spinal cord compression. It is very effective as pain control and local disease control.
National guidelines vary; some recommend the therapy for those who do not improve with other treatment. [49] It may be effective for lumbar disc herniation with radiculopathy, [50] [51] as effective as mobilization for neck pain, [52] some forms of headache, [53] [54] and some extremity joint conditions.
The second disc replacement to achieve wide clinical use was the prodisc total disc replacement; it continues to have worldwide use today. Designed by French orthopedic spine surgeon Thiery Marnay, M.D., in the late 1980s, early implantations of the prodisc device began in 1990, with a 7-11 year follow-up published in 2005.
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