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21. Diagnosis and Treatment of Lumbar Disc Herniation with Radiculopathy

of the intervertebral disc space 1 resulting in pain, weakness or numbness in a myotomal or dermatomal distribution. Work Group Consensus Statement What is the natural history of lumbar disc herniation with radiculopathy? In order to perform a systematic review of the literature regard- ing the natural history of patients with lumbar disc herniation with radiculopathy, the above definition of lumbar disc hernia - tion was developed by consensus following a global review of the literature and definitive texts (...) and nonoperative therapy for patients with a lumbar disc herniation: SPORT. Spine (Phila Pa 1976). Jan 2010. 1;35(1):89-97. 7. Awad JN, Moskovich R. Lumbar disc herniations: surgi- cal versus nonsurgical treatment. Clin Orthop Relat Res. Feb 2006;443:183-197. 8. Benoist M. The natural history of lumbar disc herniation and radiculopathy. Joint Bone Spine. Mar 2002;69(2):155-160. 9. Benson RT, Tavares SP , Robertson SC, Sharp R, Marshall RW . Conservatively treated massive prolapsed discs: a 7-year follow- up

2012 North American Spine Society

22. Sports Hernia

Sports Hernia Sports Hernia Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Sports Hernia Sports Hernia Aka: Sports Hernia II (...) . Pathophysiology Weakening of posterior inguinal wall Results in occult, non-palpable III. Symptoms Chronic deep in athlete Insidious onset with gradual worsening Radiation Inguinal ligament Perineum Rectus muscles (30%) Provocative Increased intra-abdominal pressure IV. Signs not detectable (affects posterior wall) Difficult to diagnose except during surgery V. Differential diagnosis Distal rectus strain or avulsion (medial and inferior to Sports Hernia) VI. Radiology Imaging rules out other diagnoses VII

2015 FP Notebook

23. Inguinal Hernia in Athletes: Role of Dynamic Ultrasound Full Text available with Trip Pro

and professional athletes with sports-related groin pain who underwent ultrasound were selected based on history and examination. Patients with prior groin surgery or hip pathology were excluded. Clinical and surgical documentation were correlated with imaging. The study group was compared with 41 age-matched asymptomatic athletes.Ultrasound was positive for hernia with movement of bowel, bladder, or omental tissue anterior to the inferior epigastric vessels during Valsalva maneuver. The 47-patient symptomatic (...) included 3 patients with direct inguinal hernias, 2 with indirect inguinal hernias, and 3 with femoral hernias.Inguinal hernias are a major component of groin pain in athletes. Prevalence of direct inguinal hernia in symptomatic athletes was greater than that for controls ( P < 0.001). Surgery was successful in returning these athletes to sport: 39 of 42 (93%) athletes with groin pain and inguinal hernia became asymptomatic.Persistent groin pain in the athlete may relate to inguinal hernia, which can

2017 Sports health

24. Reoperation for Recurrent Intervertebral Disc Herniation in the Spine Patient Outcomes Research Trial: Analysis of Rate, Risk Factors, and Outcome. Full Text available with Trip Pro

Reoperation for Recurrent Intervertebral Disc Herniation in the Spine Patient Outcomes Research Trial: Analysis of Rate, Risk Factors, and Outcome. This study was a post-hoc subgroup analysis of prospectively collected data in the Spine Patient Outcomes Research Trial (SPORT).The aim of this study was to determine the risk factors for and to compare the outcomes of patients undergoing revision disc excision surgery in SPORT.Risk factors for reherniation and outcomes after revision surgery have (...) not been well-studied. This information is critical for proper patient counseling and decision-making.Patients who underwent primary discectomy in the SPORT intervertebral disc herniation cohort were analyzed to determine risk factors for undergoing revision surgery. Risk factors for undergoing revision surgery for reherniation were evaluated using univariate and multivariate analysis. Primary outcome measures consisted of Oswestry Disability Index (ODI), the Sciatica Bothersomeness index (SBI

2017 Spine Controlled trial quality: uncertain

25. Endoscopic totally extraperitoneal (TEP) hernia repair for inguinal disruption (Sportsman's hernia): rationale and design of a prospective observational cohort study (TEP-ID-study). Full Text available with Trip Pro

groin (inguinal disruption).The study is being conducted in a high-volume, single centre hospital with specialty in TEP hernia repair. Patients over 18 years, suffering from inguinal pain for at least 3 months during or after playing sports, and whom have not undergone previous inguinal surgery and have received no benefit from physiotherapy are eligible for inclusion. Patients with any another cause of inguinal pain, proven by physical examination, inguinal ultrasound, X-pelvis/hip or MRI (...) are excluded.Primary outcome is reduction in pain after 3 months. Secondary outcomes are pain reduction, physical functioning, and resumption of sport (in frequency and intensity).An unrestricted research grant for general study purposes was assigned to the Hernia Centre. This study itself is not directly subject to the above mentioned research grant or any other financial sponsorship. We intend to publish the outcome of the study, regardless of the findings. All authors will give final approval of the manuscript

2016 BMJ open

26. The impact of epidural steroid injections on the outcomes of patients treated for lumbar disc herniation: a subgroup analysis of the SPORT trial. Full Text available with Trip Pro

The impact of epidural steroid injections on the outcomes of patients treated for lumbar disc herniation: a subgroup analysis of the SPORT trial. The Spine Patient Outcomes Research Trial (SPORT) is a prospective, multicenter study of operative versus nonoperative treatment of lumbar intervertebral disc herniation. It has been suggested that epidural steroid injections may help improve patient outcomes and lower the rate of crossover to surgical treatment.One hundred and fifty-four patients (...) included in the intervertebral disc herniation arm of the SPORT who had received an epidural steroid injection during the first three months of the study and no injection prior to the study (the ESI group) were compared with 453 patients who had not received an injection during the first three months of the study or prior to the study (the No-ESI group).There was a significant difference in the preference for surgery between groups (19% in the ESI group compared with 56% in the No-ESI group, p < 0.001

2012 The Journal of Bone and Joint Surgery. American Volume Controlled trial quality: uncertain

27. Return to Play After Sports Hernia Surgery. (Abstract)

Return to Play After Sports Hernia Surgery. Sports hernia is a condition that causes acute/chronic pain of low abdominal, groin, or adductor area in athletes. It is considered a weakness in the rectus abdominis insertion or posterior inguinal wall of lower abdomen caused by acute or repetitive injury of the structure. It is most commonly seen in soccer, ice hockey, and martial arts players who require acute cutting, pivoting, or kicking. A variety of surgical options have been reported (...) with successful outcome and with high rates of return to the sports in a majority of cases. Copyright © 2016 Elsevier Inc. All rights reserved.

2016 Clinics in Sports Medicine

28. Performance Outcomes and Return-to-Sport Rate of National Hockey League Athletes Vary After Common Orthopedic Surgical Procedures. (Abstract)

), noninstability shoulder arthroscopy (ie, shoulder arthroscopy procedure to address pathology other than shoulder instability), knee arthroscopy, and sports hernia repair (P = 0.002, 0.009, 0.03, and 0.01, respectively). The number of games played for seasons 2 and 3 after surgery was significantly decreased for both HA and noninstability shoulder arthroscopy (P = 0.01 and 0.001, respectively). Short-term postoperative performance scores were significantly decreased for HA, noninstability shoulder arthroscopy (...) Performance Outcomes and Return-to-Sport Rate of National Hockey League Athletes Vary After Common Orthopedic Surgical Procedures. Evaluate performance-based outcomes and return-to-sport rate in National Hockey League (NHL) athletes.Retrospective cohort study.Public records. No direct patient care was provided.National Hockey League athletes who underwent different orthopedic procedures were identified using public records. Three hundred thirty-seven athletes met inclusion criteria.Common

2018 Clinical Journal of Sport Medicine

29. Commentary on: The role of surgery for treatment of low back pain: Insights from the randomized controlled SPORT trials. Full Text available with Trip Pro

Commentary on: The role of surgery for treatment of low back pain: Insights from the randomized controlled SPORT trials. The SPORT trial database offered much useful information regarding the efficacy of surgical treatment for lumbar disc herniations, lumbar spinal stenosis, and degenerative spondylolisthesis. Data were obtained from 13 sites and included 2500 patients.The randomized trial for lumbar disc herniations was contaminated by the immense crossover of patients from surgical (50 (...) %) to non-surgical (30%) groups. Weinstein et al. concluded that they could not claim superiority of one treatment modality over the other. Weinstein's next SPORT study on lumbar discs, performed utilizing a prospective cohort of patients undergoing lumbar disc surgery (those that would not agree to be randomized), appeared to demonstrate better outcomes with vs. without surgery.The follow-up study 8 years later again questioned the value of surgery vs. non-operative intervention. The other SPORT

2016 Surgical neurology international Controlled trial quality: uncertain

30. Pediatric Return to Sports After Spinal Surgery Full Text available with Trip Pro

Pediatric Return to Sports After Spinal Surgery Pediatric patients who undergo spinal surgery are frequently involved in sporting activities. Return to play is often an important postoperative concern for the patient and family.A PubMed search was conducted for articles in the English language on return to play after treatment of pediatric acute disc herniation, degenerative disc disease, spondylolysis, spondylolisthesis, and scoliosis from 1980 to 2015. Reference lists were reviewed (...) for additional pertinent articles. We included articles that focused on return to sports after surgical treatment of these conditions in this review.Clinical review.Level 4.There are no published guidelines, and most of the literature in this area has focused on return to play after spinal injury rather than after spinal surgery. Most children and adolescents have excellent outcomes with minimal pain at 1 year after lumbar discectomy. The majority of surgeons allow return to full activity once pain-free

2016 Sports health

31. Groin Injuries in Finnish Contact Sports

Groin Injuries in Finnish Contact Sports Groin Injuries in Finnish Contact Sports - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. Groin Injuries in Finnish Contact Sports (Finngroin) The safety (...) Mikkeli Central Hospital Rigshospitalet, Denmark Information provided by (Responsible Party): Kuopio University Hospital Study Details Study Description Go to Brief Summary: The prevalence of acute and chronic groin injuries in athletes is between 5 and 10 %. This observational case-control study follows three contact sport teams (soccer, ice-hockey and bandy) for two years to find out the prevalence and reasons for groin pain. Clinical examination, pain scores and pelvic magnetic resonance imaging

2015 Clinical Trials

32. Outcomes After Lumbar Disc Herniation in the National Basketball Association Full Text available with Trip Pro

Outcomes After Lumbar Disc Herniation in the National Basketball Association Professional basketball players are at risk for lumbar disc herniation (LDH), yet the evidence guiding treatment after operative or nonoperative management of this condition in the National Basketball Association (NBA) is limited.NBA players with LDH will have different performance outcomes based on treatment type.Case-control study.Level 4.Athletes in the NBA with an LDH were identified through team injury reports (...) , transaction records, and public sports archives. A 1:2 case-control study was performed in which LDH players and players without LDH were matched for player variables. Statistical analysis was employed to compare pre- and postindex season performance (games played and player efficiency rating [PER]) and career longevity between test subjects and controls in the operatively treated (OT) and nonoperatively treated (NOT) cohorts.A total of 61 NBA players with LDH were included, of whom 34 underwent

2016 Sports health

33. The Effect of Expectations on Treatment Outcome for Lumbar Intervertebral Disc Herniation. Full Text available with Trip Pro

The Effect of Expectations on Treatment Outcome for Lumbar Intervertebral Disc Herniation. Secondary analysis of randomized and nonrandomized prospective cohorts.To examine the effect of patient treatment expectations on treatment outcomes for patients with intervertebral disc herniation.Patient expectations about treatment effectiveness may have important relationships with clinical outcomes.Subgroup and reanalysis of the Spine Patient Outcomes Research Trial, a randomized trial (...) and comprehensive cohort study enrolling patients between March 2000 and November 2004 from 13 multidisciplinary spine clinics in 11 US states. Overall, 501 randomized and 744 observational patients (1244 total) who were surgical candidates with radiculopathy and imaging confirmed lumbar intervertebral disc herniation were enrolled. The primary study compared surgical discectomy to usual nonoperative care; this subgroup analysis reassessed outcomes on the basis of treatment expectations at baseline

2015 Spine

34. A posterior ring apophyseal fracture and disc herniation in a 21-year-old competitive basketball player: a case report Full Text available with Trip Pro

A posterior ring apophyseal fracture and disc herniation in a 21-year-old competitive basketball player: a case report To describe the diagnosis and management of a competitive male basketball player with discogenic low back pain and presence of an old posterior ring apophyseal fracture (PRAF). This case will highlight the importance of early recognition and considerations regarding patient management for this differential of radiating low back pain.A 21-year-old provincial basketball player (...) therapy, interferential current, and soft tissue therapy to the lumbar spine. Rehabilitation exercises focused on centralizing symptoms and improving strength, proprioception and function of the lower limb. After a period of 8 weeks, the patient was able to complete all activities of daily living without pain in addition to returning to basketball practice.PRAF is a unique condition in the immature spine and recent evidence suggests that those involved in sports requiring repetitive motion

2015 The Journal of the Canadian Chiropractic Association

35. Three-month results of the effect of Ultrapro or Prolene mesh on post-operative pain and well-being following endoscopic totally extraperitoneal hernia repair (TULP trial). Full Text available with Trip Pro

Three-month results of the effect of Ultrapro or Prolene mesh on post-operative pain and well-being following endoscopic totally extraperitoneal hernia repair (TULP trial). Recurrence rates after inguinal hernia repair have been reduced to a few per cent, since mesh repair has become standard of care. Lightweight meshes reduce post-operative pain and stiffness in open anterior repair, but for endoscopic repair, the discussion about this benefit is ongoing. This study was done to analyse (...) the effects of lightweight mesh versus heavyweight mesh following endoscopic totally extraperitoneal (TEP) hernia repair.In a single-centre double-blindly randomized clinical trial, 950 patients with unilateral primary inguinal hernia were randomized to undergo endoscopic TEP using either an Ultrapro(®) or a Prolene(®) mesh. Data were collected by validated questionnaires at day 1, day 7, after 6 weeks and after 3 months, and clinical assessment was performed after 3 months. The presence of groin pain

2015 Surgical endoscopy Controlled trial quality: predicted high

36. Laparoscopic hernia repair with adductor tenotomy for athletic pubalgia: an established procedure for an obscure entity. (Abstract)

and ipsilateral adductor longus tenotomy. All patients were able to return to full sports-related activity in 24 days (range 21-28 days). One patient experienced urinary retention and another sustained an adductor brevis hematoma 3 months after completion of rehabilitation and surgical intervention. Mean follow up was 18 months.Athletic pubalgia is a disease with a multifactorial etiology that can be treated surgically by a laparoscopic totally extraperitoneal hernia repair with synthetic mesh accompanied (...) Laparoscopic hernia repair with adductor tenotomy for athletic pubalgia: an established procedure for an obscure entity. Athletic pubalgia is a syndrome of chronic lower abdomen and groin pain that occurs in athletes. It is the direct result of stress and microtears of the rectus abdominis inserting on the pubis from the antagonizing adductor longus muscles, and weakness of the posterior transversalis fascia and bulging of the inguinal floor.Under IRB approval, we conducted a retrospective

2015 Surgical endoscopy

37. Systematic review: People with lumbar disc herniation and associated radiculopathy benefit more from microdiscectomy than advice in the short term, although there is no difference in the long term Full Text available with Trip Pro

, variable means of diagnosis or confirmation of herniation and variety of non-operative treatments evaluated. Even the SPORT trial left the classification of ‘conservative care’ deliberately vague. Similarly, this review failed to find any overwhelmingly convincing data supporting any single conservative treatment modality over another. The limitations of this study are primarily the limitations of the trials reviewed. Because of the strict search criteria, only a small number of trials were included (...) results from the maine lumbar spine study . Weinstein JN , Tosteson TD , Lurie JD , et al . Surgical vs nonoperative treatment for lumbar disk herniation: the Spine Patient Outcomes Research Trial (SPORT): a randomized trial . Daffner SD , Hymanson HJ , Wang JC . Cost and use of conservative management of lumbar disc herniation before surgical discectomy . Weinstein JN , Lurie JD , Tosteson TD , et al . Surgical versus nonoperative treatment for lumbar disc herniation: four-year results for the Spine

2010 Evidence-Based Medicine

38. Sports Physicals (Overview)

organomegaly, especially splenomegaly, because of the risk of rupture in contact sports. Genitalia: The need for a genital examination is an area of controversy among sports medicine physicians. This examination can be used for Tanner staging in adolescents to classify athletes by maturity; thus, developmental delays can be detected. The genital examination can also be used to assess males for the presence of a single testicle and to evaluate for the presence of hernias. Some sports physicians omit (...) the genital examination unless the history indicates a single testicle or inguinal or scrotal swelling; the medical history may be adequate for finding these problems. Furthermore, unless hernias are incarcerated, sports participation may not be prohibited. Musculoskeletal: If the screening history is negative, this evaluation can be quickly completed by using the 90-second orthopedic evaluation as outlined below. Note the general body habitus. Assess the cervical range of motion. Assess shoulder function

2014 eMedicine.com

39. Sports Physicals (Treatment)

organomegaly, especially splenomegaly, because of the risk of rupture in contact sports. Genitalia: The need for a genital examination is an area of controversy among sports medicine physicians. This examination can be used for Tanner staging in adolescents to classify athletes by maturity; thus, developmental delays can be detected. The genital examination can also be used to assess males for the presence of a single testicle and to evaluate for the presence of hernias. Some sports physicians omit (...) the genital examination unless the history indicates a single testicle or inguinal or scrotal swelling; the medical history may be adequate for finding these problems. Furthermore, unless hernias are incarcerated, sports participation may not be prohibited. Musculoskeletal: If the screening history is negative, this evaluation can be quickly completed by using the 90-second orthopedic evaluation as outlined below. Note the general body habitus. Assess the cervical range of motion. Assess shoulder function

2014 eMedicine.com

40. Facial Trauma, Sports-Related Injuries

Facial Trauma, Sports-Related Injuries Sports-Related Facial Trauma: Facial Injuries, Basic Anatomy of the Face, Evaluation of Facial Injury Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMTI4NDI4OC1vdmVydmlldw (...) == processing > Sports-Related Facial Trauma Updated: Sep 13, 2016 Author: Sarah A Frommer, MD, PhD; Chief Editor: Zubin J Panthaki, MD, CM, FACS, FRCSC Share Email Print Feedback Close Sections Sections Sports-Related Facial Trauma Facial Injuries One of the most vulnerable and important parts of the human body is the face. Typically, the face is considered to be bounded superiorly and laterally by the hairline and ears and inferiorly by the lower edge of the jaw. The most common mechanisms for facial

2014 eMedicine Surgery

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