title: Massive Lumbar Disk Herniation Following "Therapeutic" Water Boiling of the Lower Extremities: Case Report and Literature Review.
abstract: BACKGROUND
  Legs burning for treating lumbar radicular pain are still in use nowadays in low socioeconomical environments. They are dangerous as the case we report shows clearly.
  
  
  METHODS
  A 49-year-old man came to our attention with severe flaccid paraparesis occurred 10 days before, almost immediately after he had immersed his legs in boiling water to treat his severe left lumbocrural pain. This was known to be due to a right L3/4 herniated disk diagnosed by magnetic resonance imaging. At the examination he showed severe motor paresis and absent reflexes of his lower limbs, while crural pain was mild and sensation and urinary function were unaffected. The results of his neurologic examination led us to suspect an acute motor axon degeneration related to thermal shock. Lumbar magnetic resonance imaging, performed before the planned electromyogram as an exception to the established routine, showed instead a giant 5- × 5.5-cm, herniated disk compressing the dural sac at L3.
  
  
  CONCLUSIONS
  Prompt surgical decompression led to rapid improvement. We discuss here the pathophysiology of this unusual case and point out how medieval practices for treating sciatica-like pain are not only unjustified from a medical viewpoint but also potentially dangerous.
authors.affiliation: Department of Surgical Sciences, Chair for Neurosurgery, Catholic University "Our Lady of Good Counsel," Tirana, Albania; Department of Clinical Neurosciences, Section of Neurosurgery, Neurological Centre of Latium-Neuromed, Rome, Italy. Electronic address: segreteria1@nclroma.it.
authors.forename: Aldo
authors.initials: A
authors.lastname: Spallone
authors.affiliation: Department of Surgical Sciences, Chair for Neurosurgery, Catholic University "Our Lady of Good Counsel," Tirana, Albania.
authors.forename: Megi
authors.initials: M
authors.lastname: Çelniku
mesh_terms: D006801:Humans; D006979:Hyperthermia, Induced / Q000009:adverse effects*; D007405:Intervertebral Disc Displacement / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery*; D035002:Lower Extremity; D008159:Lumbar Vertebrae / Q000601:surgery; D008297:Male; D008875:Middle Aged; D020335:Paraparesis / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control; D011843:Radiculopathy / Q000628:therapy; D019423:Shamanism; D013117:Spinal Cord Compression / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery*; D016896:Treatment Outcome
keywords: Giant herniated disk; Leg burning; Lumbar radicular pain; Microdiskectomy