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Related Concept Videos

Local Anesthetics: Clinical Application as Epidural Anesthesia01:29

Local Anesthetics: Clinical Application as Epidural Anesthesia

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Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
517

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Related Experiment Video

Updated: Oct 3, 2025

Full Endoscopic Interlaminar Approach for Paracentral L5-S1 Disc Herniation
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Posterior epidural intervertebral disc migration and sequestration: A systematic review.

Paolo Palmisciano1, Kishore Balasubramanian2, Gianluca Scalia3

  • 1Department of Neurosurgery, Trauma Center, Gamma Knife Center, Cannizzaro Hospital, Catania, Italy.

Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia
|February 13, 2022
PubMed
Summary

Posterior epidural intervertebral disc migration and sequestration (PEIMS) is a rare complication of degenerative disc disease. Surgical removal is the gold standard for treatment, offering significant patient recovery.

Keywords:
Degenerative disc diseaseDisc herniationSpineSpine fusionSpine surgery

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Area of Science:

  • Neurosurgery
  • Orthopedics
  • Radiology

Background:

  • Posterior epidural intervertebral disc migration and sequestration (PEIMS) is a rare complication of degenerative disc disease.
  • Accurate radiological diagnosis of PEIMS is challenging, impacting treatment planning.

Purpose of the Study:

  • To systematically review the literature on PEIMS.
  • To analyze clinical-radiological features, treatment strategies, and functional outcomes of PEIMS.

Main Methods:

  • Systematic literature review of PubMed, Scopus, Web of Science, and Cochrane databases.
  • Inclusion of 82 studies with 157 patients diagnosed with PEIMS.
  • Analysis of clinical characteristics, treatments, and outcomes.

Main Results:

  • Most common symptoms include lower-back pain and radiculopathy, often involving the L5 nerve root.
  • MRI and CT are primary diagnostic tools, with most PEIMS located in the lumbar spine.
  • Surgical debulking achieved high symptomatic improvement (97.5%) and total recovery (75.2%); conservative management also showed full recovery in a small cohort.

Conclusions:

  • PEIMS significantly impacts quality of life in patients with degenerative disc disease.
  • Surgical removal is the primary treatment for improving functional status.
  • Spine fusion and conservative strategies can also be effective in select cases.