P H Pennekamp, M Gemünd, C N Kraft, L V von Engelhardt, C Lüring, A Schmitz
{"title":"[Epidural varicosis as a rare cause of acute radiculopathy with complete foot paresis--case report and literature review].","authors":"P H Pennekamp, M Gemünd, C N Kraft, L V von Engelhardt, C Lüring, A Schmitz","doi":"10.1055/s-2007-960503","DOIUrl":"https://doi.org/10.1055/s-2007-960503","url":null,"abstract":"<p><strong>Introduction: </strong>Lumbar epidural varicosis presenting with radiculopathy is a seldom anticipated condition. An uncommon case of symptomatic enlargement of epidural veins mimicking lumbar disc herniation led us to perform a literature review to elucidate aetiopathological and diagnostic considerations as well as treatment options of this intraspinal pathology.</p><p><strong>Methods: </strong>The case of a 40-year-old woman with acute sciatia accompanied by a complete paresis of foot elevation and extension caused by enlarged epidural veins is described. A literature survey (Medline 1960-2005) was conducted to uncover further cases of symptomatic epidural varicosis.</p><p><strong>Results: </strong>The literature review revealed only 75 published cases of symptomatic epidural varices which is generally judged as a rare cause of radiculopathy. Different models for the origin of enlarged epidural veins have been proposed. Enlargement may occur primary or secondary to a herniated disc or compressive lesions in the spinal cord. In some cases obstruction or occlusion of the inferior vena cava due to pregnancy or deep vein thrombosis are suspected to increase the pressure of the epidural venous plexi via collateral pathways. MRI has been reported to be of high value in demonstrating the dilated epidural vein, but the findings might be misinterpreted as herniated nucleus pulposus material. Coagulative ablation and/or excision of enlarged epidural veins is recommended and produces good long-term results in cases without extraspinal vessel pathology.</p><p><strong>Conclusion: </strong>Enlargement of epidural veins with compression of lumbar nerve roots can mimic the clinical signs of disc herniation or spinal stenosis, even when accompanied by neurological disorders. Although rare, lumbar epidural varicosis should be appreciated as a possible cause of radiculopathy and diagnosed before surgery. Apart from intraspinal abnormalities causing dilatation of epidural veins, stenosis or occlusion of the extraspinal venous drainage system should be considered.</p>","PeriodicalId":76855,"journal":{"name":"Zeitschrift fur Orthopadie und ihre Grenzgebiete","volume":"145 1","pages":"55-60"},"PeriodicalIF":0.0,"publicationDate":"2007-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-2007-960503","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26592000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Stress on the knee joint by knee bending as prearthrosis].","authors":"M Weber","doi":"10.1055/s-2007-960508","DOIUrl":"https://doi.org/10.1055/s-2007-960508","url":null,"abstract":"<p><strong>Aim: </strong>Purpose of our study was to prove from the orthopaedic point of view whether or not osteoarthrosis of the knee joint may be regarded as an occupational disease under certain physical loads.</p><p><strong>Method: </strong>A review and meta-analysis of occupational medicine literature was undertaken, which was reported as a scientific background for the planned occupational disease study \"gonarthrose\" in Germany.</p><p><strong>Results: </strong>There exist only four relevant epidemiological studies, showing a correlation between osteoarthrosis of the knee joint and knee flexion under conditions of physiological stress. None of them proves that knee flexion causes osteoarthrosis. It may be only concluded with some restriction that occupations involving extensive kneeling or squatting influence the progress and course of osteoarthrosis of the knee--together with other pathogenetic and aetiological factors.</p><p><strong>Conclusion: </strong>It cannot be concluded from occupational studies that kneeling and squatting or similar physical strains during work cause osteoarthrosis of the tibio-femural or patello-femoral joint. On the basis of methodical epidemiological and biomechanical considerations a causative correlation as described before cannot be expected. Nevertheless, in the occupational literature one can find some circumstantial evidence which may show whether mechanical functional stress influences the course of knee arthropathy (such as early patella osteophytes, osteoarthrosis of ankle joints) or not (early tibio-femural osteoarthrosis, lack of osteophytes in the elderly).</p>","PeriodicalId":76855,"journal":{"name":"Zeitschrift fur Orthopadie und ihre Grenzgebiete","volume":"145 1","pages":"17-30"},"PeriodicalIF":0.0,"publicationDate":"2007-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-2007-960508","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26591995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Studien bestätigen Wirksamkeit von Hyaluronsäure","authors":"","doi":"10.1055/s-2006-971829","DOIUrl":"https://doi.org/10.1055/s-2006-971829","url":null,"abstract":"","PeriodicalId":76855,"journal":{"name":"Zeitschrift fur Orthopadie und ihre Grenzgebiete","volume":"44 1","pages":"560 - 561"},"PeriodicalIF":0.0,"publicationDate":"2006-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79330810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Präsidentenrede von Univ.-Prof. Dr. Jochen Eulert - am 2.10.2006 anlässlich der 92. Tagung Deutsche Gesellschaft für Orthopädie und Orthopädische Chirurgie e.V. (DGOOC) 2. bis 6. Oktober 2006, Berlin Univ.-Prof. Dr. Jochen Eulert, Präsident 2006 Bayerische Julius-Maximilians-Universität Würzburg","authors":"","doi":"10.1055/s-2006-971076","DOIUrl":"https://doi.org/10.1055/s-2006-971076","url":null,"abstract":"","PeriodicalId":76855,"journal":{"name":"Zeitschrift fur Orthopadie und ihre Grenzgebiete","volume":"19 1","pages":"547 - 548"},"PeriodicalIF":0.0,"publicationDate":"2006-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74023314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Osteoporosetherapie: Im Mittelpunkt soll der Patient stehen","authors":"","doi":"10.1055/s-2006-971830","DOIUrl":"https://doi.org/10.1055/s-2006-971830","url":null,"abstract":"","PeriodicalId":76855,"journal":{"name":"Zeitschrift fur Orthopadie und ihre Grenzgebiete","volume":"12 1","pages":"561 - 561"},"PeriodicalIF":0.0,"publicationDate":"2006-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77019414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Schneller fit mit Enzymen","authors":"","doi":"10.1055/s-2006-971831","DOIUrl":"https://doi.org/10.1055/s-2006-971831","url":null,"abstract":"","PeriodicalId":76855,"journal":{"name":"Zeitschrift fur Orthopadie und ihre Grenzgebiete","volume":"41 1","pages":"562 - 562"},"PeriodicalIF":0.0,"publicationDate":"2006-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75554425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Effects of inpatient rehabilitation for patients with back pain].","authors":"F-J Ludwig, A I Unlü, C Melzer, H H Daalmann","doi":"10.1055/s-2006-942337","DOIUrl":"https://doi.org/10.1055/s-2006-942337","url":null,"abstract":"<p><strong>Background: </strong>This prospective, randomised longitudinal study examined the effects of inpatient medical rehabilitation.</p><p><strong>Method: </strong>Data was collated on the day of admission (n=261), day of discharge (n=261) and 6 months after discharge (n=243). The length of the rehabilitation measure changed every 3 months from 3 weeks (n=127) to 4 weeks (n=134) and back again. On all three specific days the VAS, the Roland-Morris-Questionnaire (RMQ) and the SF-36 were applied. The distance between fingers and floor and the Schober-sign were measured on the first and second day. The Mainz Pain Staging System (MPSS) was used to classify pain chronicity.</p><p><strong>Results: </strong>On the day of discharge all parameters show an improvement. When the differing rehabilitation times are compared we can see the longer period scores better in VAS and Schober. 6 months after the rehabilitation all parameters show a slight improvement over the first day--except VAS--and a deterioration compared to the second--except RMQ. No significant predominance of the 4 week rehabilitation period is recognizable.</p><p><strong>Conclusion: </strong>The length of the rehabilitation measure alone seems to have no real effect on the permanence of the positive treatment of back complaints. It has advantages, though, for the result on the day of discharge.</p>","PeriodicalId":76855,"journal":{"name":"Zeitschrift fur Orthopadie und ihre Grenzgebiete","volume":"144 6","pages":"569-76"},"PeriodicalIF":0.0,"publicationDate":"2006-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-2006-942337","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26458886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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