Background: Mechanical articulated devices can replace the intervertebral disc in patients with chronic back degenerated pain. We would like to report our short-term experience with a disc prosthesis in a small group of L5-S1 disc degeneration. Methods: In a cohort study, 21 consecutive patients (17 males, 4 females) with degenerative L5-S1 disc disease with over 6 months history of disabling back symptoms non-responsive to conservative treatment were treated by disc prosthesis. The mean age was 36±5.7 years (22-48 years) at surgery and the average follow-up was 11 months (13-24 months). The cases were evaluated by visual analogue scale (VAS) for pain, Oswestry disability index (ODI) for disability, and also for personal satisfaction at 3, 6, 12 and 24 months post surgery. Results: Early improvement with pain control and return to function were seen in all patients (p<0.05). The improvement in later follow-ups was not statistically significant. The rate of satisfaction was 86 percent, and 81% drop in analgesic use was reported by the patients. No complication was encountered in this group. Conclusion: Disc arthroplasty in degenerated L5-S1 is a reasonable alternative to fusion surgery. In short-term, has a good success rate, without any major side effect.

Introduction: rupture of intervertebral disc material into the intradural compartment is a rare event, but lumbar disc disease must be considered in differential diagnosis of mass lesion causing nerve rootor cauda-equina syndromes. Any age group with the exception of children can be affected. The neurological symptoms and findings are generally more sever than lateral  Extradural disc herniation.The purpose of this study is to determine the incidence of lumbar intradural disc rupture and describeits clinical and radiological presentation.Positive mechanical findings suggesting nerve root compression or distortion are found in 75% of these patients. Radiologic evaluation of the patient with suspected intradural disc herniation is most effectively done with a combination of myelography and CT scanning. The treatment of Intradural disc herniation is surgical removal. Methods: this descriptive study is from October 1997 to September 2002, 2308 patients (mean age: 45.6 years old) with lumbar disc herniation recognized by MRI and / or myelography or CT myelogram who underwent surgery were studied. Results: mean age for this disease has been 45.6 years and males are affected more than females in a ratio of 8 to 2. Neurological findings were motoric, sensory and sphincteric disorders. The most neurological complication was dropfoot. The short time results were good.Conclusion: Lumbar intradural disc herniation must be considered in differential diagnosis of intradural mass lesions. The worse the preoperative deficit, the less likely a postoperative recovery of neurological function, therefore the "time" is very important.

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 most common causes of low back pain and after pulmonary disease, low back pain is the second most common reason to see a doctor. Diagnosis of lumbar disc herniation in a patient presenting with sciatica is based on history, clinical signs, physical examination, and MRI or CT imaging techniques. Pain Most patients who present with sciatica due to lumbar disc herniation respond to conservative and rest treatments, but patients who do not respond to medical treatment and rest undergo lumbar MRI imaging without contrast and if indicated Clinically, the presence of a disc herniation undergoes surgery with a pressure effect on the spinal sac or nerve root. Clinical indication for lumbar disc herniation surgery occurs when, despite rest, the pain persists for more than 4 weeks, due to high pressure, the person develops paresthesia in the lower extremities, the patient's pain recurs frequently and the patient's life Disrupt. Chronic diseases such as back pain have important consequences, including changes in people's quality of life. Quality of life is a multidimensional structure that is characterized by social, mental and physical vitality and causes a feeling of vitality and satisfaction with life, and certainly spinal surgery affects the quality of life in all dimensions. In the present study, the quality of patients' health before and after lumbar disc herniation surgery and the necessity of disc surgery were investigated. Methods: In this descriptive-analytical study in which samples were selected by convenience, 90 patients with chronic low back pain who were candidates for lumbar disc herniation surgery were studied. Data were collected through the 36-SF Health Quality Questionnaire and also using a demographic questionnaire, patient demographic information including age, sex, height, weight, smoking, occupation and level of education was collected. Before the operation, the 36-SF questionnaire was used to assess the quality of patients' health. After the operation, patients were followed up in two stages of 6 months and then 12 months with the help of the questionnaire and their quality of life was re-evaluated. Exclusion criteria included patients who had complications from surgery during the follow-up period, including wound infection, nerve root damage and neurological defects, incomplete recovery of lower back and lower extremity pain, and recurrence of disc herniation. They were lumbar or found a new history of other diseases such as stroke, rheumatoid arthritis, autoimmune disease, in which case they were excluded from the study. Descriptive statistics including calculation of numerical indices (mean and standard deviation) for quantitative traits and percentage for qualitative traits were used for summarization. Also, paired t-test was used to analyze quantitative data and Wilcoxon test was used if necessary and KS test was used for data normality. The stratification method was used for comparative purposes in terms of contextual variables. Then the samples were analyzed with SPSS-20 software. Results: Mean and standard deviation of score improvement in physical dimension of quality of life before and 6 months after treatment in terms of sex were 38. 60 9 9. 13 in men and 31. 90 56 8. 56 in women, which was statistically different. Was significant (p = 0. 005). Also, the mean and standard deviation of the score improvement in physical dimension of quality of life before and 12 months after treatment was 43. 58 6 6. 72 in men and 40. 37 24 7. 24 in women, which was not statistically significant (p=0. 009). The mean and standard deviation of the score improvement in the psychological dimension of quality of life before and 6 months after treatment was 18. 41 ± 11. 72 in men and 14. 26 37 7. 37 in women, which was statistically significant (p<0. 001)), also the mean and standard deviation of the score improvement in the psychological dimension of quality of life before and 12 months after treatment was estimated to be 24. 93 9 9. 69 in men and 29. 26 86 8. 86 in women, which was statistically significant. In women, there was more improvement than men. Mean and standard deviation of score improvement in physical dimension Quality of life before and 6 months after treatment in patients based on the duration of low back and lower limb pain, in two groups under 2 months and above 2 months were studied. The results showed that in the group under 2 months, 39. 06 18 7. 18 in the group above 2 months was 32. 59 36 9. 36 which was statistically significant (p=0. 012) so that Patients with less back and lower limb pain (less than 2 months) showed more improvement. Also, the mean and standard deviation of the score improvement in the physical dimension of quality of life before and 12 months after treatment in the group under 2 months was 45. 37 86 7. 86 in the group over 2 months was 38. 68 10 10. 31, which was different from Statistically significant (p=0. 08) that patients with less back and lower extremity pain (less than 2 months) showed more improvement. In general, the mean score of physical and mental health improvement was significantly different from Paying attention to body mass index, number of involved discs and smoking before, 6 and 12 months later showed that according to the results of independent t-test, the score of improving the quality of life in physical and mental dimensions; Compared to before, 6 months and 12 months after surgery were statistically significant among men and women and showed an increase in quality of life in both physical and psychological dimensions (p<0. 001). Conclusion: The results of the present study showed that the quality of life in the present study in the time periods before treatment, 6 and 12 months after treatment caused a significant improvement in the physical and mental condition of patients with lumbar disc herniation so that the mean score of quality of life Before the intervention, it was increased to 5. 94 29 29. 5, 6 months after the intervention to 60. 17 4 4. 55 and in 12 months after the intervention to 65. 26 6 6. 18, which statistical test also showed a significant increase (p<0. 001).

Spinal epidural lipomatosis is a rare condition which is described as the accumulation of fat in the extradural territory and often causes dural impingement. Spinal epidural lipomatosis has been implicated in causing a variety of neurologic impairments ranging from back pain, radiculopathy, claudication, myelopathy or even cauda equina syndrome. We report a 46-year-old female with obesity and a history of chronic back pain and radiculopathy who developed idiopathic Spinal epidural lipomatosis diagnosed by magnetic resonance imaging. The purpose of this report is to present a case of spinal epidural lipomatosis presenting with symptomatic cord compression and also remind this rare condition as a the differential diagnosis of epidural lesions in patients with risk factors.