Journal of IMAB - Annual Proceeding (Scientific Papers)
Publisher: Peytchinski, Gospodin Iliev
ISSN: 1312 773X
Issue: 2013, vol. 19, book 1;
Subject Collection: Medicine
Published online: 12 April 2013
J of IMAB. 2013; 19(1):399-401;
SIMULTANEOUS DISC HERNIATION IN PATIENTS WITH MULTIPLE SCLEROSIS
Kalina V. Drenska1, Ara G. Kaprelyan1, Alexandra J. Tzoukeva1, Radoslav Georgiev2, Ilia T. Todorov3
1) Department of Neurology, 2) MRI Sector, Department of Radiology, 3) Clinic of Physical therapy and Balneology,
Medical University of Varna, Bulgaria.
Background: Multiple sclerosis (MS) is a chronic autoimmune, inflammatory demyelinating disease of the central nervous system. Commonly, MS patients present with accompanying degenerative vertebral disc diseases. Simultaneous disc herniations situated in the cervical or lumbosacral spine can mimic the clinical symptoms of MS and worsen patients’ quality of life.
Objective: to investigate the incidence rate and clinical impact of accompanying disc herniations in patients with MS.
Material and methods: Our study covered 330 patients (220 females and 110 males, mean age 40.5±12.4 years) with clinically definite MS, according to McDonald’s criteria. Comprehensive neurological examinations, EDSS (Expanded Disability Status Scale) assessments, and MRI neuroimaging were carried out. Statistical data processing was performed by using the method of variation analysis.
Results: Relapsing-remitting MS (RRMS) was diagnosed in 280 patients while 50 patients presented with secondary progressive MS (SPMS). Disc herniation was found in 64 (19.4%) of our patients. Cervical disc pathology was detected in 38 patients (11.5% of the cases) and lumbosacral - in 26 (7.9% of the cases). EDSS scores ranged from 2.5 to 5.5. EDSS evaluation showed statistically significantly worse scores in MS patients with disc herniation comorbidity (p<0, 05).
Conclusion: Our own data confirm the assumption that MS patients often present with accompanying degenerative disc pathology. We suggest that comorbidity of disc herniation and MS exert an additional unfavorable effect on patient’s disability and individual quality of life.
Key words: Multiple sclerosis, disc herniation, comorbidity.
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Please cite this article as:
Drenska KV, Kaprelyan AG, Tzoukeva AJ, Georgiev R, Todorov I. SIMULTANEOUS DISC HERNIATION IN PATIENTS WITH MULTIPLE SCLEROSIS. J of IMAB. 2013; 19(1):399-401. DOI: 10.5272/jimab.2013191.399.
Correspondence to: Kalina Drenska, MD. University Hospital "St. Marina", Varna, Bulgaria.
1. Balériaux D, Deroover N, Hermanus N, Segebarth C. MRI of the spine. Diagn Imaging Clin Med. 1986; 55(1-2):66-71. [PubMed]
2. Bashir K, Hadley MN, Whitaker JN. Surgery for spinal cord compression in multiple sclerosis. Curr Opin Neurol. 2001 Dec;14(6):765-769. [PubMed]
3. Bradley WG. Use of gadolinium chelates in MR imaging of the spine. J Magn Reson Imaging. 1997 Jan-Feb;7(1)38-46. [PubMed]
4. Devonshire V, Havrdova E, Radue EW, O'Connor P, Zhang-Auberson L, Agoropoulou C, et al. Relapse and disability outcomes in patients with multiple sclerosis treated with fingolimod: subgroup analyses of the double-blind, randomised, placebo-controlled FREEDOMS study. Lancet Neurol. 2012 May;11(5):420-428. [PubMed] [CrossRef]
5. Ghajarzadeh M, Sahraian MA, Fateh R, Daneshmand A. Fatigue, depression and sleep disturbances in Iranian patients with multiple sclerosis. Acta Med Iran. 2012; 50(4):244-249. [PubMed]
6. Guclu-Gunduz A, Citaker S, Nazliel B, Irkec C. Upper extremity function and its relation with hand sensation and upper extremity strength in patients with multiple sclerosis. NeuroRehabilitation. 2012; 30(4):369-374. [PubMed] [CrossRef]
7. Jaracz K, Pawlak M, Górna K, Kołcz B, Wołoszyn D, Kozubski W. Quality of life and social support in patients with multiple sclerosis. Neurol Neurochir Pol. 2010 Jul-Aug;44(4):358-65. [PubMed]
8. Korovessis P, Maraziotis T, Stamatakis M, Baikousis A. Simultaneous three-level disc herniation in a patient with multiple sclerosis. Eur Spine J. 1996 5(4):278-280. [PubMed]
9. Phan-Ba R, Calay P, Grodent P, Delrue G, Lommers E, Delvaux V, et al. Motor fatigue measurement by distance-induced slow down of walking speed in multiple sclerosis. PLoS One. 2012; 7(4):e34744. [PubMed] [CrossRef]
10. Poser CM. MRI of spinal cord in multiple sclerosis. Lancet, 341, 1993 Apr 17;341(8851):1025. [PubMed]
11. Roosen N, Dietrich U, Nicola N, Irlich G, Gahlen D, Stork W. MR imaging of calcified herniated thoracic disk. J Comput Assist Tomogr. 1987 Jul-Aug;17(4):733-735. [PubMed]
12. Rotstein D, O'Connor P, Lee L, Murray BJ. Multiple sclerosis fatigue is associated with reduced psychomotor vigilance. Can J Neurol Sci. 2012 Mar;39(2:180-184. [PubMed]
13. Wetzel JL, Fry DK, Pfalzer LA. Six-minute walk test for persons with mild or moderate disability from multiple sclerosis: performance and explanatory factors. Physiother Can. 2011 Spring;63(2):166-180. [PubMed] [CrossRef]
14. Young WF, Weaver M, Mishra B. Surgical outcome in patients with coexisting multiple sclerosis and spondylosis. Acta Neurol Scand. 1999 Aug;100(2):84-87. [PubMed]
Accepted for publication: 23 November 2012
Published online: 12 April 2013
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