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Herniated Intervertebral Disc l: Introduction

Intervertebral disc herniation refers to the displacement of the nucleus pulposus (the gel-like inner core of the disc) through a tear or weakened area in the annulus fibrosus (the outer fibrous ring). The displaced disc material extends beyond the normal boundaries of the disc space and may compress or irritate nearby spinal nerve roots or, less commonly, the spinal cord.Etiology and Risk FactorsHerniation commonly results from degeneration, in which aging reduces disc hydration and...
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Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...
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Spinal Nerves: Plexus II

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Vascular Spasm01:16

Vascular Spasm

The vascular phase, also known as vasospasm, is the initial stage of hemostasis, crucial for preventing excessive bleeding when a blood vessel is injured. After a vessel is cut, nerves in the damaged area trigger pain and other sensory impulses. Simultaneously, the smooth muscles in the vessel wall contract, resulting in a vascular spasm. This contraction reduces the vessel's diameter at the injury site, slowing or stopping blood loss through the vessel wall. Vascular spasms typically last for...
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Related Experiment Video

Updated: Jun 25, 2026

Spinal Hernia Repair and Cauda Equina Repositioning After Lumbar Decompression under Three-Dimensional Microscopy: A Case Report and Literature Review
04:33

Spinal Hernia Repair and Cauda Equina Repositioning After Lumbar Decompression under Three-Dimensional Microscopy: A Case Report and Literature Review

Published on: November 8, 2024

An uncommon cause of sciatica.

Muhammad Shakeel1, Manickam Kumaravel, James M Mackenzie

  • 1Department of Surgery, University of Aberdeen, UK. drshakeel@doctors.org.uk

Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
|February 12, 2009
PubMed
Summary
This summary is machine-generated.

Metastatic renal cell carcinoma can infiltrate nerve roots, causing back pain and sciatica. This rare condition should be considered in patients with a history of cancer presenting with these symptoms.

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Area of Science:

  • Oncology
  • Neurosurgery
  • Radiology

Background:

  • Renal cell carcinoma (RCC) is a common malignancy.
  • Back pain and sciatica are frequently caused by degenerative spinal conditions.

Observation:

  • A 67-year-old male with a history of left nephrectomy for RCC presented with right-sided back pain and sciatica.
  • MRI revealed a lesion in the S1 root canal, initially suspected to be a neurofibroma.
  • Surgical exploration identified a lesion originating from the S2 nerve root.

Findings:

  • Histopathology confirmed metastatic renal cell carcinoma infiltrating the S1 and S2 nerve roots and dorsal root ganglion.
  • The patient experienced complete resolution of pain after surgical excision.

Implications:

  • Nerve root infiltration by metastasis is an uncommon but critical differential diagnosis for back pain and sciatica.
  • A history of malignancy should prompt consideration of metastatic disease in patients with neurological symptoms.
  • Early diagnosis and treatment of metastatic nerve root infiltration can lead to favorable outcomes.