Sciatica Symptoms

Sciatica is characterized by pain radiating from the back into the buttock and into the leg. The pain may travel below the knee and may also involve the foot.

Sciatica Symptoms

• Pain radiate from the buttock to the leg and foot. There may also be needling or numbness in the region.
• In the more severe case, the leg may become weak.
• The pain feels like an electric shock suddenly or persistently.
• The whole buttock, thigh and leg become tender on touching.
• The leg muscles become very tense and spastic.
• Pain can affect sleep and causes insomnia.
• Cough, sneezing, laughing and sitting may aggravate the pain

Reference: http://www.brain-spine.com.hk

The information provided aims to provide educational purpose, if you have the described conditions as above, please consult your neurosurgeon immediately.

Sciatica Symptoms

Sciatica is characterized by pain radiating from the back into the buttock and into the leg. The pain may travel below the knee and may also involve the foot.

Sciatica Symptoms

• Pain radiate from the buttock to the leg and foot. There may also be needling or numbness in the region.
• In the more severe case, the leg may become weak.
• The pain feels like an electric shock suddenly or persistently.
• The whole buttock, thigh and leg become tender on touching.
• The leg muscles become very tense and spastic.
• Pain can affect sleep and causes insomnia.
• Cough, sneezing, laughing and sitting may aggravate the pain

Reference: http://www.brain-spine.com.hk

The information provided aims to provide educational purpose, if you have the described conditions as above, please consult your neurosurgeon immediately.

What is Stroke?

Stroke is sudden onset of neurological disability. It happens because of sudden blockage of blood vessel in the brain or sudden bleeding in the brain. Within minutes, the affect part of the brain dies. On average, every year, 26,000 new patients suffer from stroke in Hong Kong. The peak time for onset of stroke is when temperature suddenly drops, e.g. around November to December.

Symptoms of stroke

The symptoms of stroke include
(1) weakness or numbness of the face, arm or leg,
(2) confusion and drowsiness,
(3) difficult to speak,
(4) dizziness,
(5) blurring of vision,
(6) severe headache,
(7) incontinenece,
(8) vomiting,
(9) coma.

Mini-stroke means patients suffered for one or more of the above named symptoms, but only temporarily.




Reference: http://www.brain-spine.com.hk/index-english.html
The information provided aims to provide educational purpose, if you have the described conditions as above, please consult your neurosurgeon.

   

Intervertebral disc disease

The structure of vertebral column

Vertebral column composes of 33 vertebra (spinal column bones) including 7 cervical, 12 thoracic, 5 lumbar and 5 fused sacrum and 4 fused coccyx. Its major function is to support the body and protect the spinal cord.

The 7 cervical vertebra are separated by fibrous tissue, i.e. intervertebral disc. This disc gives spine the flexibility to move and absorb shock during body movement.

The vertebrae encircles and protects your spinal cord. Nerves branching from the spinal cord pass through openings in the vertebrae to other parts of your body. This gives your body sensation and enables your body to perform different activity and motion.


Intervertebral disc degeneration

As intervertebral disc loses their water content because of disease or age, they lose their height and bring vertebrae closer together. The consequence is weakening of the shock absorption properties of the disc and a narrowing of the openings for the nerves in the sides of the spine. Additionally, a loss of intervertebral disc height may cause the formation of bone spurs, which can push against your spinal cord and/or nerves.

When a intervertebral disc ruptures in the cervical spine, it puts pressure on one or more nerve roots or on the spinal cord, causing pain and other symptoms in the neck and arms.

Cervical artificial disc surgery

To manage degenerative disc disease in cervical region, one of treatment method is cervical artificial disc implantation. Cervical artificial disc is an artificial implantable device. In use, this device can replace the pathological cervical disc and helps the spinal nerve alleviating from pressure after the pathological disc is removed.

Intervertebral disc replacement procedure

1. The patient takes a supine position and is under general anesthesia. A small incision is made at the anterior of the neck.
2. With the assistance of microscope and various surgical instruments, neurosurgeon removes the degenerative cervical disc from the patient.
3. Then, surgeon uses special surgical instruments to prepare a site on the bone of cervical vertebrae for implantation of the cervical artificial disc.
4. Finally, the cervical artificial disc is implanted; replacing the degenerative disc and thus the motion of the neck is maintained.
5. The incision is finally closed with suture and the surgery is completed.

Patient should always consult their doctors’ opinions when choosing suitable cervical artificial disc.

Cervical artificial disc vs fusion

A fusion procedure may treat your short-term symptoms, alleviating neck and arm pain. However, clinical evidence suggests that physical stress to vertebrae involved in a fusion may accelerate disc degeneration elsewhere in your neck.

In contrast, the cervical artificial disc prosthesis replaces the disc removed by the neurosurgeons. As the artificial disc is designed to allow motion at the treated level, the issue of physical stress mentioned above is alleviated.



Reference: http://www.brain-spine.com.hk/index-english.html
The information provided aims to provide educational purpose, if you have the described conditions as above, please consult your neurosurgeon.

Sciatica Symptoms

Sciatica is characterized by pain radiating from the back into the buttock and into the leg. The pain may travel below the knee and may also involve the foot.

Sciatica Symptoms

• Pain radiate from the buttock to the leg and foot. There may also be needling or numbness in the region.
• In the more severe case, the leg may become weak.
• The pain feels like an electric shock suddenly or persistently.
• The whole buttock, thigh and leg become tender on touching.
• The leg muscles become very tense and spastic.
• Pain can affect sleep and causes insomnia.
• Cough, sneezing, laughing and sitting may aggravate the pain

Reference: http://www.brain-spine.com.hk

The information provided aims to provide educational purpose, if you have the described conditions as above, please consult your neurosurgeon immediately.

How Can I Prevent Back Pain During My Pregnancy?

To optimize your chances of keeping back pain at bay, there are a variety of preventive measures you can take:

·         First, maintain a reasonable activity level and — under your doctor's supervision — incorporate exercises that gently stretch and strengthen your back and abdominal muscles. "Keep moving!" advises Dr. Peters. "The ability and motivation to remain active is very important during this time."

·         If you spend your days behind a desk, take advantage of opportunities to get up and stretch your legs — and back — while getting your work done.

·         Maintaining good posture as your body changes is also important. As your center of gravity shifts forward, minimize the strain on your lower back by standing as straight as possible, keeping your shoulders back and your buttocks tucked under. When sitting, keep your feet slightly elevated, if possible. Choose a chair that supports your back — use a small pillow if necessary — and change positions frequently.

·         Be mindful of body mechanics. If you need to pick something up, don't bend over and lift using your back. Instead, squat using your knees, keeping your back straight as you lift. Avoid positions that require bending or twisting. Listen to your body — if something hurts, don't do it!

·         Don't be a slave to fashion. If you're hooked on high-heeled shoes, kick the addiction — at least for a few months. Cute "sensible shoes" do exist — just look for low heels and good arch support. Your clothing can also be back-friendly — look for maternity pants with a low, supportive waistband. Later in your pregnancy, you may want to use a support belt under your lower abdomen.

·         It may seem like the impossible dream at this point in your life, but do try to get a sufficient amount of sleep. Practice relaxation techniques, and keep stress to a minimum. Sleep on your side rather than your back, keeping your knees bent. Place pillows around your abdomen for support, if needed.

Reference: www.back.com., www.ispine.com.hk

The information provided aims to provide educational purpose, if you have the described conditions as above, please consult your neurosurgeon.

Hong Kong Project Brings hope to cancer kid

 

Seventeen years old Wei Qunqun from a poor farmer family in rural Shangdong Province, had acoustic neuroma (hearing-nerve cancer). But, thanks to the humanitarian efforts by “Healing Heart Initiative” Charity Program, she could undergo the surgery free of charge in Hong Kong.

A Hong Kong Hospital charity project “Healing Heart Initiative” and charity group Hear Talk Foundation paid Wei’s medical bills.

Since she was 13, acoustic neuroma badly affected Wei’s learning ability and left her almost crippled. Her hearing ability and sense of balance worsened two years ago. She always felt dizzy and could hardly walk.

The disease could have been fatal if the five-centimeter tumor continued to grow.

However, except for a tiny part that is close to her facial nerve, the tumor had been successfully removed last week by a team of volunteer doctors from Hear Talk Foundation. Wei is able to eat, think and walk and is currently undergoing physiotherapy. She will be released from hospital next week.

Reference: http://www.surgery.cuhk.edu.hk/neuro/default.htm

The information provided aims to provide educational purpose, if you have the described conditions as above, please consult your neurosurgeon.

Lower Cervical, Thoracic, and Lumbar Ligaments

The important ligamentous structures of the lower cervical, thoracic, and lumbar spine are discussed below.

The ANTERIOR LONGITUDINAL Ligament (ALL) is composed of thick, longitudinally oriented fibers extending from the axis (C2) anteriorly to the sacrum. The ALL is broader at the level of each vertebral body than at the level of the discs where the fibers adhere to the annulus fibrosus. The ALL attaches to each vertebral body superiorly and inferiorly at the levels of the endplates.

The Intertransverse Ligaments extend from the inferior surface of the entire length of the transverse process to the superior surface of the adjacent transverse process.

The Costalligaments connect the heads of the ribs to the vertebrae.

The POSTERIOR LONGITUDINAL LIGAMENT (PLL) is weaker than the ALL. Its fibers are also longitudinally oriented, but are less dense. It runs from the axis (C2) caudally to the sacrum. The PLL is narrow at the levels of the vertebrae, but the fibers extend laterally at the disc levels. These fibers may help to contain herniated disc material. Like the ALL, the PLL is attached to the vertebra at the superior and inferior margins, and to the annular fibers of the intervertebral disc.

Reference: www.neuropainhk.org

The information provided aims to provide educational purpose, if you have the described conditions as above, please consult your neurosurgeon.

Neuropathic Pain Syndromes

Postherpetic neuralgia

      - occurs following an acute attack of herpes zoster (shingles). It is defined as pain persisting for more than 3 months after the active herpes zoster lesions have healed, and involves constant aching, burning or itching with intermittent, severe, lancinating pain. Allodynia and hyperalgesia may also occur.

Peripheral or painful diabetic neuropathy

      - a peripheral, autonomic or cranial nerve disorder associated with diabetes mellitus. These conditions usually result from diabetic microvascular injury involving small blood vessels that supply nerves. It is estimated that over 50% of diabetic patients may experience a neuropathy during their lifetime, although not all neuropathies are painful. Painful neuropathy is generally described as superficial and affects the feet and hands. Burning, tingling and allodynia are typically reported.

Trigeminal neuralgia

-          affects any of the 3 trigeminal nerves that supply either side of the face, and can sometimes affect 2 branches at once. The 1-sided pain of trigeminal neuralgia may extend through the cheek, mouth, nose and/or jaw muscles. This condition is characterized by a lancinating, shooting, electric-like sensation that can last from a few seconds to several minutes. Pain may be initiated by stimulating trigger points on the face, lips or gums, or by facial muscle movement, such as chewing.

Reference: http://www.neuropainhk.org

The information provided aims to provide educational purpose, if you have the described conditions as above, please consult a neurosurgeon.

Hydrodiscetomy: Cutting with Water

Hydrodiscetomy is solving unmet needs and improving outcomes in spine surgery by providing fluidjet-driven medical devices for use in ‘open’ and ‘minimally
invasive’ spine procedures.

The products empower neurosurgeons to simultaneously cut, ablate, and remove hard and soft tissue quickly, safely, and effectively— without the collateral thermal or mechanical trauma of other surgical modalities. Imagine being able to remove tissue during back
surgery via an opening the size of a straw—with the aid of a hair-thin, 600-miles-per-hour stream of water, instead of a one- to two-inch incision from an ‘open’ surgery with a
scalpel. Although high-pressure water jets have been employed for many years in
industrial cutting applications, this technology is not easily adapted for use in medicine
because of the unique technical requirements of surgery:

(1) the working fluid must be sterile;
(2) the tools must be tiny and easily maneuverable;
(3) the pump system must be small enough to fit in any operating room; and,
(4) the devices must be safe.

Hydrodiscetomy has overcome the major barriers to the transfer of fluidjet technology from industrial to surgical applications with significant technical innovations. As a result, a growing number of neurosurgeons are using Hydrodiscetomy to wash away patients’ pain in a variety of back procedures. Unique to Hydrodiscetomy’s devices is the use of a ‘collector’ tube, not only to capture the fluidjet stream, but also to create a powerful ‘Venturi’- and-morcellation effect at the active site—resulting in tissue being drawn into the collector tube and thus away from the operative site, without the need for an external suction connection. This also allows optimal visibility during operation of the device—particularly important in spine procedures, where the surgical site is surrounded by vital structures such as nerves and blood vessels. A further major advantage of Hydrodiscetomy is the ability to achieve ‘selective’ tissue excision. The tissue selectivity benefit allows spine surgeons to quickly and safely remove appropriate tissue, such as disc nucleus, without damaging the surrounding harder tissue or vertebral endplates. These advantages illustrate the power and versatility of Hydrodiscetomy to provide solutions to the spine surgeon, enabling efficient surgical procedures and optimal patient outcomes.

Reference: http://www.minimally-invasive-centrehk.com/english/resources/resources_neurosurgery.html
http://www.youtube.com/user/HKHealthConcern#p/u/5/pFLIV3UfQgg

The above information serves as educational reference only, you should consult your neurosurgeon for diagnosis, treatments and surgeries.

Neuropathic Pain Syndromes in Hong Kong (Sciatica, cancer pain, post-stroke pain, trigeminal neuralgia, etc..)

Trigeminal neuralgia

It impacts any of the 3 trigeminal nerves that supply either side of the face, and can sometimes affect 2 branches at once. The 1-sided pain of trigeminal neuralgia may extend through the cheek, mouth, nose and/or jaw muscles. This condition is characterized by a lancinating, shooting, electric-like sensation that can last from a few seconds to several minutes. Pain may be initiated by stimulating trigger points on the face, lips or gums, or by facial muscle movement, such as chewing.

Sciatica

It is characterized by pain radiating from the back into the buttock and into the leg. The pain may travel below the knee and may also involve the foot. Lower leg muscles may become numb or weak. Sciatica is most commonly caused by prolapse of the intervertebral disc. This term is also used to describe pain anywhere along the sciatic nerve.

Cancer pain

It can be nociceptive, neuropathic or mixed in nature. Neuropathic pain in cancer patients can occur via various mechanisms, such as by nerve compression or injury caused directly by the tumour, or by cancer treatments, such as chemotherapy. Common symptoms include spontaneous burning pain, intermittent sharp or stabbing pain, hyperalgesia and allodynia.

Post-stroke pain

It is characterized by pain in body areas that have lost sensory innervation due to disruption of the spinothalamic tract as a direct result of the stroke.

Postherpetic neuralgia

It is a neuropathic pain syndrome that occurs following an acute attack of herpes zoster (shingles). It is defined as pain persisting for more than 3 months after the active herpes zoster lesions have healed, and involves constant aching, burning or itching with intermittent, severe, lancinating pain. Allodynia and hyperalgesia may also occur.

Peripheral or painful diabetic neuropathy

It is a peripheral, autonomic or cranial nerve disorder associated with diabetes mellitus. These conditions usually result from diabetic microvascular injury involving small blood vessels that supply nerves. It is estimated that over 50% of diabetic patients may experience a neuropathy during their lifetime, although not all neuropathies are painful. Painful neuropathy is generally described as superficial and affects the feet and hands. Burning, tingling and allodynia are typically reported.

Painful upper limb

It describes a range of painful syndromes affecting the upper limbs, such as carpal tunnel syndrome and tennis elbow. Carpal tunnel syndrome is caused by compression of the median nerve in the hand as it passes through the carpal tunnel, a narrow passage in the wrist comprised of bone and the transverse carpal ligament. Overuse, injury, friction, fractures, fluid retention and forceful movements are common causes. One of the first symptoms of carpal tunnel syndrome is numbness in the hand, thumb, index finger and middle finger, soon followed by pain in the same area.

Complex regional pain syndrome

It describes a variety of syndromes that may follow injury, commonly to an extremity. Patients describe their pain as constant, burning, aching and throbbing, and this may be combined with autonomic and tissue changes at the injury site. The pain usually begins days to weeks after the injury, and persists beyond the time normally expected for the injury to heal. The pain tends to radiate to an entire anatomic region, such as the distal leg and foot.

Reference information: www.spineuniverse.com, www.brainspine.com.hk, www.back.com.

The information above is used for educational purpose only, for any enquiries, please consult your neurosurgeon for medical advices.