STUDY DESIGN: Clinical, radiologic, and neurophysiologic description of 2 cases. OBJECTIVE: To describe 2 cases with spontaneous deep unilateral abdominal pain as the first symptom of thoracic disc herniation at a low thoracic vertebral level, further manifested by unilateral partial paresis of the obliquus abdominis muscle. SUMMARY OF BACKGROUND DATA: Clinical manifestation of lateral thoracic disc herniation with electrophysiologic results and conservative therapy as treatment of choice when spinal cord functions are preserved. METHODS: Magnetic resonance imaging revealed bilateral paramedian disc protrusions at T12-L1 in Patient 1 and foraminal herniation at T10-T11 and paramedian herniation at T11-T12 in Patient 2. Electromyography (EMG) and evoked potentials were investigated in the acute stage and after 6 months. RESULTS: Spontaneous activity on needle EMG confirmed axonal root impairment. Somatosensory and motor-evoked potentials were within normal limits and excluded spinal cord involvement. Nonsteroidal anti-inflammatory drugs and periradicular injection of steroids and local anesthetics rendered both patients pain-free. Normalization of muscle strength within 3 to 6 months was accompanied by EMG findings of reinnervation. CONCLUSION: Lateral disc herniation causing compression of a thoracic root associated with unilateral segmental paresis of the abdominal wall is a rare condition. Despite EMG documentation of axonal root lesion, however, a purely conservative therapeutic approach may be considered treatment of choice in cases without spinal cord involvement.

• MeSH
• antiflogistika nesteroidní terapeutické užití   MeSH
• bolesti břicha etiologie   patologie   patofyziologie   MeSH
• břišní svaly inervace   patofyziologie   MeSH
• dospělí MeSH
• elektromyografie MeSH
• evokované potenciály fyziologie   MeSH
• hrudní obratle patologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• magnetická rezonanční tomografie MeSH
• míšní kořeny účinky léků   patologie   patofyziologie   MeSH
• obnova funkce účinky léků   fyziologie   MeSH
• paréza etiologie   patologie   patofyziologie   MeSH
• steroidy terapeutické užití   MeSH
• svalová síla účinky léků   fyziologie   MeSH
• výhřez meziobratlové ploténky komplikace   patologie   patofyziologie   MeSH
• výsledek terapie MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH
• práce podpořená grantem MeSH
• Názvy látek
• antiflogistika nesteroidní MeSH
• steroidy MeSH

The paper presents the definition of failed back surgery syndrome (FBSS), current surgical treatment options and other pain control options. Available data indicates an occurrence rate of FBSS in 5-50% of cases. A steep increase of the number of performed spinal procedures has also led to an increase in the number of FBSS cases. FBSS is caused by a complex relation of different causes: biological, psychological. social and economic. Patient selection and correct indications are of key importance for successful surgical treatment of FBSS. The pathology to be addressed must be clearly defined in imaging studies, in order to perform the procedure that will yield optimal results. In over 50% with FBSS a psychological or behavioral dysfunction can be noted, and identification of such condition is part of FBSS prevention protocols. Surgical techniques for FBSS treatment include decompression, stabilization and fusion and dynamic neutralization procedures. These techniques are discussed in the paper.

• MeSH
• bolesti zad etiologie   chirurgie   MeSH
• chronická nemoc MeSH
• lidé MeSH
• ortopedické výkony * MeSH
• peroperační komplikace MeSH
• pooperační komplikace MeSH
• reoperace MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH