Little information is at hand on the diagnostic values of the clinical symptoms and signs in the level diagnosis of patients with lower lumbar DISC HERNIATION. We examined one hundred and thirty nine consecutive candidates for lower lumbar DISCectomy. Monoradicular pain with sings attributed to the fifth lumbar and first sacral root dysfunctions were evaluated independently in each patient. Intra-operatively, all patients were assessed by a single neurosurgeon for the level of DISC HERNIATION. We reached the conclusion that the diagnostic vale of clinical features of the herniated fifth lumbar DISC is higher than that of the fourth lumbar DISC HERNIATION. The value of clinical presentation in the level diagnosis of lower lumbar DISC HERNIATION is highly specific, but rather insensitive.

Introduction: The aims of this study was to estimate prevalence, Clinical finding and results of operation and long term outcome of lumber intervertebral DISC HERNIATION in children less than 15 years of age.Method of study and Results: Out of 1232 patients with Lumber DISC HERNIATION (L.D.H.) admitted Ghaem Hospital since 1985 to 1999.Ten children (8-15 years) underwent surgery for L.D.H. Six patients were female and four were male. The chief complaints were low back pain, lower limb pain, or both. The most common evolved intervertebral DISC was L4-L5.The results of operation were favorable and the patients became symptom free. They were followed for 1-13 years, no recurrence was observed.Conclusion: The conservative treatment in H.L.D. in children is not satisfactory and surgery preferable.

A woman presenting with severe right lower quadrant (RLQ) abdominal pain is presented here. She was evaluated for all usual cause of such pain. Laboratory tests and abdominal and pelvic sonography was normal. MRI revealed L1-L2 DISC HERNIATION.

This article reports the outcome of a series of patients who received surgical treatment for lumbar DISC HERNIATION during a 5 year period in Kashani hospital. Three operative procedures were used for DISCectomy: unilateral interlaminar bilateral interlaminar and bilateral laminectomy. An objective method of assessing outcome that would not depend on the procedures, the prolo functional-economic outcome rating scale used to evaluate patients. Most patients had good outcome. The patient with non-industrial injuries had better had good outcome. The patient with non-industrial injuries had better outcome. The prolo scale appears to be a useful tool for comparing different procedures more objectively and for comparing the outcome across series.

Introduction: Surgical treatment of Lumbar DISC HERNIATION (LDH) is one of the most common surgeries in the world. In many studies the success is related to the radiological results. The aim of this study, however, is to determine the effects of some psychological factors such as depression, anxiety and patients’ expectations concerning their satisfaction from Disk HERNIATION surgery (DHS).Materials and Methods: Sixty patients who were candidates for DHS were examined for depression, expectations, anxiety and satisfaction before and three months after the surgery using standard questionnaires.Results: The patients consisted of 33 females (55%) and 27 males (45%). The average of pain acuity before the surgery was measured as 7.25 units which decreased to 2.1 units after the operation. 93.3% of the subjects were diagnosed with anxiety of different degrees and 66.7% with depression. 70% had high expectations. The patients’ satisfaction rate was ranging from 1.7 to 8.9 (mean= 5.5).  Satisfaction gained the highest rate in the patients aging between 30-39 years old. Also, depression and high expectations were found to be associated with lower levels of satisfaction.Conclusion: Depression decreases patient’s satisfaction while low expectations can increase it.

Background & Aim: Low back pain is the most debilitating condition, and can lead to decreased physical function, compromised quality of life, and psychological distress. Several studies have been conducted to recognize the risk factors of low back pain, but despite of strong relationship between obesity and low back pain, the underlying mechanisms are unclear. The aim of this study was to evaluate the association between obesity/overweight and DISC height and DISC bulging at each level and total levels in lumbar vertebra, considering occupational risk factors.Methods & Materials/Patients: This is a cross-sectional study on 102 patients with low back pain referring to MRI department in Poursina hospital in Rasht. Body mass index (kg/m2) categories modified for Asian populations based on World Health Organization guidelines were used. DISC height and DISC HERNIATION were evaluated in sagittal T1, sagittal T2 and axial T2 MRI images. We used four risk factors agreed by US-NIOSH (USA-National Institute for Occupational Safety and Health), to evaluate the occupational risk factors.Regression test was used for statistical analysis.Results: Of the 102 patients, 36.3% were men and 63.7% were women. The age range was 15 to 75 years. Results showed that 26.5% of patients had normal body mass index, 39.2% were overweight and 34.3% were obese. Low, moderate, and high level of occupational risk factors were distributed as 36.3%, 17.6%, and 46.1%, respectively. Analysis with regression test showed that the relationship between obesity and overweight and DISC height was negative at total levels and all levels, unless L5-S1. At L5-S1 level, there was no association.There was a positive relationship between obesity and total score of DISC HERNIATION at L1-S1. There was no association between overweight and total score at this level. At L1-L2, L2-L3 and L5-S1, there were no association between obesity and overweight and DISC HERNIATION, and at L3-L4 and L4-L5, there were negative relationships between obesity and DISC HERNIATION.Conclusion: Our study noted the positive and significant association between obesity/overweight and DISC degenerative changes in lumbar spine. Since there is abundant evidence in the literature demonstrating the strong association of DISC degeneration on MRI with low back pain, prevention and treatment of being overweight or obese must be a public health priority.

Background: Lumbar DISC HERNIATION is one of the common causes of low back pain in the third or fourth decade of life. Thorough clinical evaluation is the best method for diagnosis and localization of level of pathology. Paraclinical tests, including MRI are commonly used for confirmation of diagnosis and even in decision-making about treatment. MRI is, however, a very sensitive imaging study and its value as a primary diagnostic test is questionable. We have, therefore, decided to study the importance of obtaining MRI in suspected cases of lumbar DISC HERNIATIONs.Material and Methods: In a 21/2 years period, all the cases who had been referred to our center as candidates for DISC-hemiation surgery, were evahiated. A total of 110 patients who had MRI study were enrolled into this study. The correlation of MRI findings with patients clinical evaluation, and response to treatment was studied.Results: In 35 of 110 cases, the MRI findings matched their clinical evaluation. 40 cases (36.4%) had inadequate signs and symptoms of DISC HERNIATION but positive MRI for such a pathology. 5 cases (4.5%) had lumbar DISC HERNIATION clinically while MRI was negative. 3 patients not only had evidence for DISC HERNIATION clinically which matched the MRI findings, but also had abnormalities in other levels.Conclusions: Diagnosis of lumbar DISC HERNIATION is best done on clinical grounds MRI is only useful to confirm the clinical diagnosis. A positive MRI without sufficient clinical evidence should never be used to plan surgery.