Bilateral lumbar transforaminal epidural steroid injection

The follow-up of the patients produced contradictory results, which indicated that bilateral cingulotomy is not the optimal treatment for OCD. [17] Of the 44 patients, only 32% both fit the "responder" criteria and showed significant improvement compared to the other subjects. Another 14% exhibited some signs of improvement. Multiple cingulotomies correlated with a higher likelihood of continuing to respond to follow-up inquiries (6% more often fit the full "responder" criteria, 11% more often fit the partial "responder" criteria. However, the side effects associated with the procedure were numerous. Among the complaints that patients had after the surgery were apathy and deficits in memory, although these were rarely reported. In addition, some subjects complained of some form of urinary disturbance, ranging from urinary retention to incontinence . Hydrocephalus (2%) and seizures (2%) were also observed. [17]

() A 32-year-old man underwent a lumbar microdiskectomy and an incidental dural tear occurred. A hemilaminectomy was performed to obtain adequate visualization of the defect, and primary repair of the tear was performed. One month postoperatively he returns to the office complaining of severe headaches and occasional nausea which is worse with standing. He denies fever or chills. On physical exam his wound is well healed with no cellulitis or erythema. WBC and ESR are within normal limits. What is the most likely diagnosis? Review Topic

Usually, foraminal narrowing only affects a single nerve root on one side of the body. However, some patients may experience bilateral foraminal narrowing, caused by nerve compression on both sides of the spine. Typically, the symptoms of bilateral foraminal narrowing include pain that develops over the course of time, often a number of years (the majority of patients are over 50). Most patients with foraminal narrowing or bilateral foraminal narrowing do not experience continuous pain, but rather have pain when they assume certain positions or engage in certain activities.

The diagnosis was never conclusive to me, since there was no verified bilateral nerve compression, although it is possible that some of the cauda equina is affected by a large central herniation at L5/S1. Now, I feel that my later discovered cervical herniations are more probable as the source of most of my suffering, at least structurally. One intervertebral bulge, in particular, really displaces the spinal cord severely and this may explain the incredible diversity of symptoms I endure. I place far more credence in this theory than in the lumbar disc-enactment suspicions.

Bilateral lumbar transforaminal epidural steroid injection

bilateral lumbar transforaminal epidural steroid injection

The diagnosis was never conclusive to me, since there was no verified bilateral nerve compression, although it is possible that some of the cauda equina is affected by a large central herniation at L5/S1. Now, I feel that my later discovered cervical herniations are more probable as the source of most of my suffering, at least structurally. One intervertebral bulge, in particular, really displaces the spinal cord severely and this may explain the incredible diversity of symptoms I endure. I place far more credence in this theory than in the lumbar disc-enactment suspicions.

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