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The remaining cases developed pathology at a different level, or on the opposite side, but at the same level as the surgery was performed. In theory, all failed back patients have some sort of nerve injury or damage which leads to a persistence of symptoms after a reasonable healing time. [59] [60] [132]
These changes, such as bulging disks, thickening of ligaments and overgrowth of bone spurs, lead to pressure and potentially damage to the spinal nerve roots. [2] The compression of the spinal nerve roots that control movements and sensations in the lower body subsequently causes the symptoms of NC. [5]
Spinal fusion is a high risk surgery and complications can be serious, including death. In general, there is a higher risk of complications in older people with elevated body mass index (BMI), other medical problems, poor nutrition and nerve symptoms (numbness, weakness, bowel/bladder issues) before surgery. [4]
Nerve decompressions and resections are the only treatments with a known cure rate. It is a common clinical experience, that even chronic entrapments with longstanding muscle weakness and sensory disturbances sometimes show a very rapid reversibility of some or all of the symptoms after surgical decompression of the nerve. [5]
Denervation can occur as a consequence of nerve injury. The three primary categories of nerve injury are neurapraxia, axonotmesis, and neurotmesis, each corresponding to varying degrees of damage and potential for recovery. In cases of nerve injury, the brain demonstrates an impressive ability to rewire or reorganize its neuronal circuitry ...
[46] [47] Patients with a nude nerve root, where the root sleeve is absent, are at increased risk for developing recurrent CSF leaks. [48] Lumbar disc herniation has been reported to cause CSF leaks in at least one case. [49] Degenerative spinal disc diseases cause a disc to pierce the dura mater, leading to a CSF leak. [24]
After the conus medullaris (near lumbar vertebral levels 1 (L1) and 2 (L2), occasionally lower), the spinal canal contains a bundle of nerve fibers (the cauda equina or "horse-tail") that branches off the lower end of the spinal cord and contains the nerve roots from L1–L5 and S1–S5. The nerve roots from L4–S4 join in the sacral plexus ...
Symptoms for spinal tumors may vary due to factors such as the type of tumor, the region of the spine, and the health of the patient. Back pain is the most common symptom and it can be a problem if the pain is severe, has a time frame that lasts longer than it would for a normal injury, and becomes worse while laying down or at rest.
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