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41. Cervical Spine Injuries in Sports (Diagnosis)

and second images below) or MRI (see the third and fourth images below). Once the diagnosis of acute disk herniation with neurologic symptoms is made, an anterior diskectomy with interbody fusion may be necessary. Axial CT scan of cervical herniated nucleus pulposus. Myelogram of cervical herniated disk. A filling defect is shown. T1-weighted MRI of a cervical disk herniation. T2-weighted MRI of cervical disk herniation. In contrast to the rarity of acute disk herniations in contact sports, disk injuries (...) without frank herniation or neurologic injury can be common and are characterized by chronic changes. Chronic disk changes frequently are seen in athletes who compete in contact sports. Albright studied cervical spine radiographs of 75 University of Iowa freshmen football recruits. [ ] The radiographs were obtained after the individuals played high school football but before they played college football. Albright found that 32% had one or more of the following conditions: Occult fracture Vertebral

2014 eMedicine Surgery

42. Cervical Spine Injuries in Sports (Overview)

and second images below) or MRI (see the third and fourth images below). Once the diagnosis of acute disk herniation with neurologic symptoms is made, an anterior diskectomy with interbody fusion may be necessary. Axial CT scan of cervical herniated nucleus pulposus. Myelogram of cervical herniated disk. A filling defect is shown. T1-weighted MRI of a cervical disk herniation. T2-weighted MRI of cervical disk herniation. In contrast to the rarity of acute disk herniations in contact sports, disk injuries (...) without frank herniation or neurologic injury can be common and are characterized by chronic changes. Chronic disk changes frequently are seen in athletes who compete in contact sports. Albright studied cervical spine radiographs of 75 University of Iowa freshmen football recruits. [ ] The radiographs were obtained after the individuals played high school football but before they played college football. Albright found that 32% had one or more of the following conditions: Occult fracture Vertebral

2014 eMedicine Surgery

43. Sports Physicals (Follow-up)

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

44. Sports Physicals (Diagnosis)

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

45. Cervical Spine Injuries in Sports (Treatment)

and second images below) or MRI (see the third and fourth images below). Once the diagnosis of acute disk herniation with neurologic symptoms is made, an anterior diskectomy with interbody fusion may be necessary. Axial CT scan of cervical herniated nucleus pulposus. Myelogram of cervical herniated disk. A filling defect is shown. T1-weighted MRI of a cervical disk herniation. T2-weighted MRI of cervical disk herniation. In contrast to the rarity of acute disk herniations in contact sports, disk injuries (...) without frank herniation or neurologic injury can be common and are characterized by chronic changes. Chronic disk changes frequently are seen in athletes who compete in contact sports. Albright studied cervical spine radiographs of 75 University of Iowa freshmen football recruits. [ ] The radiographs were obtained after the individuals played high school football but before they played college football. Albright found that 32% had one or more of the following conditions: Occult fracture Vertebral

2014 eMedicine Surgery

46. Cervical Spine Injuries in Sports (Follow-up)

and second images below) or MRI (see the third and fourth images below). Once the diagnosis of acute disk herniation with neurologic symptoms is made, an anterior diskectomy with interbody fusion may be necessary. Axial CT scan of cervical herniated nucleus pulposus. Myelogram of cervical herniated disk. A filling defect is shown. T1-weighted MRI of a cervical disk herniation. T2-weighted MRI of cervical disk herniation. In contrast to the rarity of acute disk herniations in contact sports, disk injuries (...) without frank herniation or neurologic injury can be common and are characterized by chronic changes. Chronic disk changes frequently are seen in athletes who compete in contact sports. Albright studied cervical spine radiographs of 75 University of Iowa freshmen football recruits. [ ] The radiographs were obtained after the individuals played high school football but before they played college football. Albright found that 32% had one or more of the following conditions: Occult fracture Vertebral

2014 eMedicine Surgery

47. Disk Herniation

''Connell MJ, Ryan M, Powell T, Eustace S. The value of routine MR myelography at MRI of the lumbar spine. Acta Radiol . 2003 Nov. 44(6):665-72. . Lurie JD, Tosteson AN, Tosteson TD, Carragee E, Carrino J, Kaiser J, et al. Reliability of magnetic resonance imaging readings for lumbar disc herniation in the Spine Patient Outcomes Research Trial (SPORT). Spine . 2008 Apr 20. 33(9):991-8. . Peterson CK, Leemann S, Lechmann M, Pfirrmann CW, Hodler J, Humphreys BK. Symptomatic magnetic resonance imaging (...) Disk Herniation Disk Herniation Imaging: Overview, Radiography, Computed Tomography 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=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMzQwMDE0LW92ZXJ2aWV3 processing > Disk Herniation Imaging Updated: Mar 10, 2017

2014 eMedicine Radiology

48. Herniated Nucleus Pulposus (Diagnosis)

treatment of ruptured lumbar disks. Surg Clin North Am . 1953 Dec. 33(6):1545-9. . Weber H. Lumbar disc herniation. A prospective study of prognostic factors including a controlled trial. Part I. J Oslo City Hosp . 1978 Mar-Apr. 28(3-4):33-61. . Weinstein JN, Lurie JD, Tosteson TD, et al. Surgical vs nonoperative treatment for lumbar disk herniation: the Spine Patient Outcomes Research Trial (SPORT) observational cohort. JAMA . 2006 Nov 22. 296(20):2451-9. . Strange DG, Fisher ST, Boughton PC, Kishen TJ (...) , Diwan AD. Restoration of compressive loading properties of lumbar discs with a nucleus implant-a finite element analysis study. Spine J . 2010 Jul. 10(7):602-9. . Weinstein JN, Lurie JD, Tosteson TD, Tosteson AN, Blood EA, Abdu WA, et al. Surgical versus nonoperative treatment for lumbar disc herniation: four-year results for the Spine Patient Outcomes Research Trial (SPORT). Spine . 2008 Dec 1. 33(25):2789-800. . Meredith DS, Huang RC, Nguyen J, Lyman S. Obesity increases the risk of recurrent

2014 eMedicine Surgery

49. Diaphragmatic Hernias, Acquired (Diagnosis)

Diaphragmatic Hernia Updated: Dec 17, 2018 Author: Anne T Saladyga, MD; Chief Editor: Jeffrey C Milliken, MD Share Email Print Feedback Close Sections Sections Acquired Diaphragmatic Hernia Overview Background The diaphragm is the major muscle of respiration. Diaphragmatic excursion and chest wall expansion increase the negative intrathoracic pressure required for inhalation. The sequelae from diaphragmatic rupture and subsequent herniation of intra-abdominal contents are associated with significant (...) rupture during labor. Int J Obstet Anesth . 2004 Oct. 13 (4):284-6. . Hayden JD, Davies JB, Martin IG. Diaphragmatic rupture resulting from gastrointestinal barotrauma in a scuba diver. Br J Sports Med . 1998 Mar. 32 (1):75-6. . Emamaullee JA, Nekrasov V, Gilmour S, Kneteman N, Yanni G, Kohli R, et al. Case series and systematic review of acquired diaphragmatic hernia after liver transplantation. Pediatr Transplant . 2018 Oct 2. e13296. . Mansour KA. Trauma to the diaphragm. Chest Surg Clin N Am

2014 eMedicine Surgery

50. Diaphragmatic Hernias, Acquired (Overview)

Diaphragmatic Hernia Updated: Dec 17, 2018 Author: Anne T Saladyga, MD; Chief Editor: Jeffrey C Milliken, MD Share Email Print Feedback Close Sections Sections Acquired Diaphragmatic Hernia Overview Background The diaphragm is the major muscle of respiration. Diaphragmatic excursion and chest wall expansion increase the negative intrathoracic pressure required for inhalation. The sequelae from diaphragmatic rupture and subsequent herniation of intra-abdominal contents are associated with significant (...) rupture during labor. Int J Obstet Anesth . 2004 Oct. 13 (4):284-6. . Hayden JD, Davies JB, Martin IG. Diaphragmatic rupture resulting from gastrointestinal barotrauma in a scuba diver. Br J Sports Med . 1998 Mar. 32 (1):75-6. . Emamaullee JA, Nekrasov V, Gilmour S, Kneteman N, Yanni G, Kohli R, et al. Case series and systematic review of acquired diaphragmatic hernia after liver transplantation. Pediatr Transplant . 2018 Oct 2. e13296. . Mansour KA. Trauma to the diaphragm. Chest Surg Clin N Am

2014 eMedicine Surgery

51. Pediatric Hernias (Treatment)

of the buttocks. Depending on the side of the hernia, the ipsilateral leg is then externally rotated and completely flexed into the frog position. This position causes the external ring to ascend so that it more nearly, but not completely, overrides the internal inguinal ring. Once both of these conditions have been established, the first 2 fingers of the guiding hand are placed over the hernial bulge and overriding the upper margin of the external inguinal ring in such a fashion as to prevent the hernia (...) in the treatment of children with hernias. Previous Next: Activity See the list below: No specific limitations are indicated once the diagnosis of an inguinal hernia has been established; however, following operative repair, avoidance of major physical activity for 1 week is recommended. After that time, the patient is allowed to participate in physical activities (eg, sports, swimming, running). Children younger than 5 years are likely to recover extremely quickly from surgery; they are typically capable

2014 eMedicine Pediatrics

52. Hydrocele and Hernia in Children (Follow-up)

Hydrocele and Hernia in Children (Follow-up) Pediatric Hydrocele and Hernia Surgery Treatment & Management: Medical Care, Surgical Care, Complications 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 (...) =aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMTAxNTE0Ny10cmVhdG1lbnQ= processing > Pediatric Hydrocele and Hernia Surgery Treatment & Management Updated: Nov 13, 2018 Author: Joseph Ortenberg, MD; Chief Editor: Marc Cendron, MD Share Email Print Feedback Close Sections Sections Pediatric Hydrocele and Hernia Surgery Treatment Medical Care No medical therapy is effective for a hernia or a communicating hydrocele. Aspiration and injection of sclerosing agents have been recommended for noncommunicating hydroceles in adults, but this therapy is relatively

2014 eMedicine Pediatrics

53. Herniated Nucleus Pulposus (Treatment)

of nonoperative treatment of ruptured lumbar disks. Surg Clin North Am . 1953 Dec. 33(6):1545-9. . Weber H. Lumbar disc herniation. A prospective study of prognostic factors including a controlled trial. Part I. J Oslo City Hosp . 1978 Mar-Apr. 28(3-4):33-61. . Weinstein JN, Lurie JD, Tosteson TD, et al. Surgical vs nonoperative treatment for lumbar disk herniation: the Spine Patient Outcomes Research Trial (SPORT) observational cohort. JAMA . 2006 Nov 22. 296(20):2451-9. . Strange DG, Fisher ST, Boughton PC (...) , Kishen TJ, Diwan AD. Restoration of compressive loading properties of lumbar discs with a nucleus implant-a finite element analysis study. Spine J . 2010 Jul. 10(7):602-9. . Weinstein JN, Lurie JD, Tosteson TD, Tosteson AN, Blood EA, Abdu WA, et al. Surgical versus nonoperative treatment for lumbar disc herniation: four-year results for the Spine Patient Outcomes Research Trial (SPORT). Spine . 2008 Dec 1. 33(25):2789-800. . Meredith DS, Huang RC, Nguyen J, Lyman S. Obesity increases the risk

2014 eMedicine Surgery

54. Diaphragmatic Hernias, Acquired (Treatment)

. The generally accepted protocol in the acute setting is that a diaphragmatic rupture is approached via a celiotomy because concomitant intra-abdominal injuries are more likely to be present than thoracic injuries are (84% vs 53%). [ ] The problem regarding which approach to use arises when the diaphragmatic injury goes unnoticed for months or years. More surgeons approach long-standing hernias via a transthoracic or thoracoabdominal approach because the herniated intra-abdominal contents tend to be firmly (...) the diaphragm. Previous Next: Long-Term Monitoring Recurrence is possible after traumatic herniation or a congenital diaphragmatic hernia that was repaired in an adult. Therefore, after an anatomic defect is corrected, periodic assessments of pulmonary function and chest radiography are important (see the image below). Although the spontaneous recurrence rate for repaired diaphragmatic hernias is low, small defects in the repair site have been reported; therefore, surveillance is crucial. Postoperative

2014 eMedicine Surgery

55. Hydrocele and Hernia in Children (Treatment)

Hydrocele and Hernia in Children (Treatment) Pediatric Hydrocele and Hernia Surgery Treatment & Management: Medical Care, Surgical Care, Complications 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 (...) =aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMTAxNTE0Ny10cmVhdG1lbnQ= processing > Pediatric Hydrocele and Hernia Surgery Treatment & Management Updated: Nov 13, 2018 Author: Joseph Ortenberg, MD; Chief Editor: Marc Cendron, MD Share Email Print Feedback Close Sections Sections Pediatric Hydrocele and Hernia Surgery Treatment Medical Care No medical therapy is effective for a hernia or a communicating hydrocele. Aspiration and injection of sclerosing agents have been recommended for noncommunicating hydroceles in adults, but this therapy is relatively

2014 eMedicine Pediatrics

56. Herniated Nucleus Pulposus (Overview)

treatment of ruptured lumbar disks. Surg Clin North Am . 1953 Dec. 33(6):1545-9. . Weber H. Lumbar disc herniation. A prospective study of prognostic factors including a controlled trial. Part I. J Oslo City Hosp . 1978 Mar-Apr. 28(3-4):33-61. . Weinstein JN, Lurie JD, Tosteson TD, et al. Surgical vs nonoperative treatment for lumbar disk herniation: the Spine Patient Outcomes Research Trial (SPORT) observational cohort. JAMA . 2006 Nov 22. 296(20):2451-9. . Strange DG, Fisher ST, Boughton PC, Kishen TJ (...) , Diwan AD. Restoration of compressive loading properties of lumbar discs with a nucleus implant-a finite element analysis study. Spine J . 2010 Jul. 10(7):602-9. . Weinstein JN, Lurie JD, Tosteson TD, Tosteson AN, Blood EA, Abdu WA, et al. Surgical versus nonoperative treatment for lumbar disc herniation: four-year results for the Spine Patient Outcomes Research Trial (SPORT). Spine . 2008 Dec 1. 33(25):2789-800. . Meredith DS, Huang RC, Nguyen J, Lyman S. Obesity increases the risk of recurrent

2014 eMedicine Surgery

57. Diaphragmatic Hernias, Acquired (Follow-up)

. The generally accepted protocol in the acute setting is that a diaphragmatic rupture is approached via a celiotomy because concomitant intra-abdominal injuries are more likely to be present than thoracic injuries are (84% vs 53%). [ ] The problem regarding which approach to use arises when the diaphragmatic injury goes unnoticed for months or years. More surgeons approach long-standing hernias via a transthoracic or thoracoabdominal approach because the herniated intra-abdominal contents tend to be firmly (...) the diaphragm. Previous Next: Long-Term Monitoring Recurrence is possible after traumatic herniation or a congenital diaphragmatic hernia that was repaired in an adult. Therefore, after an anatomic defect is corrected, periodic assessments of pulmonary function and chest radiography are important (see the image below). Although the spontaneous recurrence rate for repaired diaphragmatic hernias is low, small defects in the repair site have been reported; therefore, surveillance is crucial. Postoperative

2014 eMedicine Surgery

58. Herniated Nucleus Pulposus (Follow-up)

of nonoperative treatment of ruptured lumbar disks. Surg Clin North Am . 1953 Dec. 33(6):1545-9. . Weber H. Lumbar disc herniation. A prospective study of prognostic factors including a controlled trial. Part I. J Oslo City Hosp . 1978 Mar-Apr. 28(3-4):33-61. . Weinstein JN, Lurie JD, Tosteson TD, et al. Surgical vs nonoperative treatment for lumbar disk herniation: the Spine Patient Outcomes Research Trial (SPORT) observational cohort. JAMA . 2006 Nov 22. 296(20):2451-9. . Strange DG, Fisher ST, Boughton PC (...) , Kishen TJ, Diwan AD. Restoration of compressive loading properties of lumbar discs with a nucleus implant-a finite element analysis study. Spine J . 2010 Jul. 10(7):602-9. . Weinstein JN, Lurie JD, Tosteson TD, Tosteson AN, Blood EA, Abdu WA, et al. Surgical versus nonoperative treatment for lumbar disc herniation: four-year results for the Spine Patient Outcomes Research Trial (SPORT). Spine . 2008 Dec 1. 33(25):2789-800. . Meredith DS, Huang RC, Nguyen J, Lyman S. Obesity increases the risk

2014 eMedicine Surgery

59. TEP Versus Open Repair of Sportsman's Hernia

TEP Versus Open Repair of Sportsman's Hernia TEP Versus Open Repair of Sportsman's Hernia - 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. TEP Versus Open Repair of Sportsman's Hernia (sports hernia (...) (TEP) technique in general anesthesia for the treatment of Sportsman´s hernia/athletic pubalgia. The primary endpoint is patient being free from intractable groin pain during sports activity or daily work four weeks after surgery. Study Design Go to Layout table for study information Study Type : Interventional (Clinical Trial) Estimated Enrollment : 60 participants Allocation: Randomized Intervention Model: Parallel Assignment Masking: Single (Outcomes Assessor) Primary Purpose: Treatment Official

2013 Clinical Trials

60. Giant Ventral Incisional Hernia: Abdominal Wall Function, Respiratory Performance and Quality of Life

is complex. Correction of giant incisional hernias including a relatively new and minimally invasive technique, (endoscopic components separation) offers promising results. This procedure allows the abdominal muscles to be joined centrally restoring the integrity of the abdominal wall. The treatment of patients with giant hernia is now centralized at Bispebjerg Hospital allowing for a joint study between surgeons, pulmonologists, and sports medicine researchers to define the functional and biophysical (...) Giant Ventral Incisional Hernia: Abdominal Wall Function, Respiratory Performance and Quality of Life Giant Ventral Incisional Hernia: Abdominal Wall Function, Respiratory Performance and Quality of Life - 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

2013 Clinical Trials

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