Spine
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Four cases of computed tomography and magnetic resonance imaging documented lumbar nerve root compression associated with a vacuum disc communicating with the epidural space are presented. ⋯ Although the vacuum disc is considered a common imaging finding of no or not much pathologic significance, occasionally intradiscal gas may leak into the spinal canal. Detection of an epidural gaseous collection at the same level with a vacuum disc strongly suggests a communication between the intervertebral disc and the epidural space. Epidural gas collections can be implicated as a possible cause of radicular symptoms and should be considered in the differential diagnosis of lumbar radiculopathy.
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Case Reports
Malignant pleural mesothelioma presenting as low back pain: diagnosed by bone scan coordinating with F-18 FDG PET/CT.
Case report. ⋯ The present case highlights both the value of a Tc-99m MDP bone scan when MPM presents, unusually, as low back pain, and the importance of carefully interpreting bone scan images, especially for photopenic defects. It also indicates the usefulness of F-18 FDG PET/CT study in MPM in a difficult histopathological diagnosis.
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Epidemiological analysis using CTs. ⋯ The incidence of lumbar spondylolysis in the Japanese general population was 5.9% (males: 7.9%, females: 3.9%).
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Hydrostatically induced disruption of flexed lumbar intervertebral discs followed by microstructural investigation. ⋯ Flexion places the anulus at risk by facilitating nuclear flow, limiting circumferential disruption while promoting radial rupture, and rendering the endplate/vertebra junction vulnerable to failure. Flexion may play a developmental role in those herniations possessing a central posterior radial rupture that incorporates a short span of endplate disruption along the apex of the vertebral rim.
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We investigated the mechanism of discogenic low back pain using an in vitro model. ⋯ Extracted medium from the NP and AF promoted axonal growth. Furthermore, NGF from the NP promoted axonal growth and induced SP. These in vitro results may suggest that NGF from the NP promotes the growth of sensory nerve fibers innervating the degenerated intervertebral disc and may induce SP related with pain transmission.