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Current concepts in management of lumbar disc prolapse

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Presented by: Dr Paul Licina — Spine surgeon Event: Challenges in the Sporting Spine - 2014

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DISCECTOMY Paul Licina
surgery is a last resort these get better by themselves weakness doesn’t improve more trouble in the future
HISTORY • pain for six weeks • leg pain > back pain • radicular pain EXAMINATION • nerve compression signs • nerve tension signs INVESTIGATIONS • MRI shows concordant herniation THE PERFECT INDICATION
HISTORY • intolerable pain EXAMINATION • functional weakness INVESTIGATIONS • MRI shows huge herniation EARLIER SURGERY
HISTORY • moderate pain for less than six weeks • nonradicular pain EXAMINATION • no positive supporting findings INVESTIGATIONS • MRI shows small herniation ROLE OF STEROID NERVE ROOT BLOCK
BARRICAID TRIAL all patients followed in trial since April 2014 52 discectomies performed 21 patients consented 6 Barricaid devices implanted

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Current concepts in management of lumbar disc prolapse

  • 2. surgery is a last resort these get better by themselves weakness doesn’t improve more trouble in the future
  • 3. HISTORY • pain for six weeks • leg pain > back pain • radicular pain EXAMINATION • nerve compression signs • nerve tension signs INVESTIGATIONS • MRI shows concordant herniation THE PERFECT INDICATION
  • 4. HISTORY • intolerable pain EXAMINATION • functional weakness INVESTIGATIONS • MRI shows huge herniation EARLIER SURGERY
  • 5. HISTORY • moderate pain for less than six weeks • nonradicular pain EXAMINATION • no positive supporting findings INVESTIGATIONS • MRI shows small herniation ROLE OF STEROID NERVE ROOT BLOCK
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  • 20. BARRICAID TRIAL all patients followed in trial since April 2014 52 discectomies performed 21 patients consented 6 Barricaid devices implanted