AUCTORES
Globalize your Research
Case Report | DOI: https://doi.org/10.31579/2690-1919/140
1 Spinal Surgery Working Group, Department of Neurosurgery of the Institute of Neurology and Neurosurgery, Havana, Cuba.
2 Department of Pathological Anatomy of the Institute of Neurology and Neurosurgery, Havana, Cuba.
*Corresponding Author: Norbery J. Rodríguez de la Paz, MD, Institute of Neurology and Neurosurgery of Cuba, Department of Neurosurgery, Spinal Surgery Working Group, 29th street to D, Vedado, Habana. Cuba.
Citation: Norbery J. Rodríguez de la Paz., Oscar Q. Osorio., Alemán Bacallao AD., Hancco Huillca SE., Andrés Ortiz García, et al (2021) Intradural Dorsolumbar Disc Herniation: Case Report and Literature Review. J Clinical Research and Reports, 7(2); DOI: 10.31579/2690-1919/140
Copyright: © 2021 Norbery J. Rodríguez de la Paz, This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Received: 28 January 2021 | Accepted: 23 February 2021 | Published: 03 March 2021
Keywords: intradural disc herniation; herniated lumbar disc; magnetic resonance imaging; laminoplasty; discectomy
Intradural disc herniation is a rare entity, representing between 0.26% and 0.30% of all herniated discs. 92% of cases occur in the lumbar spine, more frequent at the L4-L5 level. The diagnostic and therapeutic conduct performed in a 61-year-old male patient who came to the office with a one-year and six-month history of dorsolumbar pain is described, accompanied by sensory alterations in the lower limbs. In view of the exacerbation of symptoms, a simple magnetic resonance study was performed, observing an intraspinal, intradural, extramedullary lesion at the D12-L1 space. An intradural disc herniation is suspected.After being evaluated the case in the group of Neurosurgeons (Group of Spinal Surgery) of the Institute of Neurology and Neurosurgery of Havana, it is proposed to carry out surgical treatment, which consisted of the extraction with microsurgical technique of the Herniated disc, preserving the vertebral anatomy through the laminoplasty technique, an open book variant. The patient evolved satisfactorily after three months of follow-up. It is concluded that intradural disc herniation should be included among intradural, extraxial lesions of the spine. By means of the magnetic resonance study, a group of imaging signs that support the preoperative diagnosis of this lesion can be described. Surgery is the definitive therapeutic method and allows an accurate diagnosis of spinal herniation to be established
Herniated discs represent a common manifestation of degenerative spinal disease. They originate from a tension failure of the annulus fibrosus to contain the nuclear portion of the disc in gel form [1]. Intradural disc herniation (IHD) constitutes a condition where the nucleus pulposus moves into the dural sac, separating from the intervertebral disc, previously passing through the posterior common longitudinal ligament (LLCP) [2]. In 1942 Dandy published the first case of a patient with HDI, since then only a low percentage of them have been reported in the medical literature. This entity represents between 0.26% and 0.30% of all herniated discs, 3% occurs in the cervical region, 5% in the thoracic region, and 92% occurs in the lumbar spine, more frequent at the L4- level. L5. There is a predominance in males, during the fifth and sixth decades of life. The patient frequently presents a picture of chronic back pain with acute exacerbation of pain accompanied by a rapidly onset focal motor defect [2, 3].
Magnetic resonance imaging (MRI) with or without contrast can demonstrate the level of herniation and its possible intradural location, but only intraoperative findings confirm intradural disc extrusion. Surgical treatment for spinal disc herniation is usually subsequent open surgery with standard durotomy to remove herniated disc fragments, with good to fair results. In cases of late presentation, a worse result occurs [4].
Due to the low incidence of intradural disc herniation, less than 1%, the difficulties in its diagnosis and the complexity of the surgical treatment, a case of a patient with a D12-L1 HDI is presented, with the aim of describing the diagnostic and therapeutic conduct based on a review of the literature.
61-year-old male patient with dorsolumbar pain of one year and six months of evolution, pain of mild to moderate intensity, with irradiation to the gluteal region, with transitory improvement after the administration of analgesics and antineuritics. Later it begins with a burning sensation, cramping and numbness in the posterior region of the thighs and legs. In the last 2 months the pain becomes intense and persistent, making it impossible for him to walk and making defecation difficult as it is very painful. He experienced no relief despite drug treatment, rectal ozone therapy, and nerve blocks.
On physical examination, antalgic left dorsolumbar scoliosis was observed. The flexion-extension and lateralization movements of the trunk, gait, the sitting position (more than 5 minutes) and the Valsalva maneuvers cause intense pain in the dorsolumbar region. Palpation of paravertebral muscle masses is painful (D10-L5). Presence of hyposesthesia and dysesthesia in the gluteal region, posterior thigh and legs bilaterally. Normal patellar and achillian osteotendinous reflexes.
In high field magnetic resonance study (3T) (Figure 1). In sagittal view (in T2 weighting) hypointense image of 1 x 1 cm is observed, of intra-spinal, intradural, extramedullary location at the level of the intervertebral space D12-L1, at the point of transition from the medullary cone to the cauda equina, which with fragment of intervertebral disc. In axial section (T2 weighting) the lesion in the form of a “hawk beak” is observed, anterior to the nerve structures, which produces compression of these. Signs of channel narrowing are seen from L2 to S1, more accentuated at the level of L5-S1.
In the gadolinium-contrasted MRI study, T1-weighted, heterogeneous enhancement of the ring-shaped contrast is observed (Figure 2).
Given the clinical and imaging findings, an intradural disc herniation is diagnosed at the D12-L1 level, without ruling out other intradural, extramedullary entities. A surgical approach is followed through a posterior approach to the thoracolumbar spine. In the prone position, with the upper extremities extended, under general anesthesia, a 7cm incision is made at the level of the midline, centered on the D12-L1 interspace, dissected by planes until identifying the thoracolumbar fascia, which is opened in line media, preserving the supraspinatus ligament, the paravertebral musculature is deiostized and laminoplasty is performed in the open book variant, cutting the right D12-L1 sheets bicortically and the left ones monocortically at the laminophacete junction. The dural sac is exposed and under microscope visualization a 2 cm long right paramedian durotomy is performed. A greyish-white lesion is immediately observed, with few adhesions to the sac and nerve structures, it is carefully dissected from caudal to cephalad, until its extraction (Figure 3A and B). We proceed to repair the ventral potion of the sac and close the durotomy (hermetic durorrhaphy). The D12-L1 sheets are repositioned and fixed (Figure 3C) and the closure is completed by planes to the skin.
The diagnosis of intradural disc herniation is confirmed by pathological study that reports fibrocartilaginous tissue with myxoid degeneration and calcifications, ossification of part of the bone marrow formation tissue and areas of cartilage necrosis compatible with nucleus pulposus (Figure 4).
The patient had a hospital stay of 5 days, evolving favorably, with considerable improvement in symptoms at discharge. A regular outpatient follow-up was carried out, recovering fully 3 months after surgery.
Intradural disc herniation represents a rare entity in spinal surgery, it can be considered a complication of an intervertebral disc herniation where perforation of the posterior common longitudinal ligament (LLCP) and dura mater occurs5. The location at the level of the lumbar spine is the most frequent (92%), with the following distribution: L4 – L5 (55%), L3 – L4 (16%), L5 – S1 (10%) [3]. In the reviewed studies, no cases were reported with location of the IHD at the dorsolumbar level (T12-L1) as described in this patient.
Its etiopathogenesis is not yet clear, several authors have described a group of factors responsible for its occurrence: a) adhesions between the fibrous ring, the CLL and the dura mater (congenital or acquired), b) congenital stenosis of the spinal canal, with reduction of the epidural space, c) congenital or iatrogenic thinning of the dura mater [6].
Patients with this condition generally describe a history of chronic back pain, with severe exacerbation of the condition and a progressive neurological defect [7]. At the level of the lumbar region, it may present as a Cauda Equina Syndrome in two thirds of patients or simulate the insidious installation of a spinal tumor [8].
HDIs are often misdiagnosed, confused with other extra medullary intradural lesions such as schwannomas, neurofibromas, lipomas, meningiomas, squamous tumor, arachnoid cyst, ganglioneuroma or metastasis [2,8,9]. In this case, preoperative diagnostic doubts were raised, not ruling out the possibility of other intradural injuries.
Improvements in advanced imaging techniques have made it increasingly possible to recognize lumbar disc hernias in symptomatic and asymptomatic individuals [1,2]. MRI with or without contrast is the method of choice for the diagnosis of IHD. The classic image is a mass originating from the intervertebral disc with signal hypointensity in T1 and T2 weights. Imaging findings include discontinuity of the LLCP, entry point of the disc into the dural sac, variable enhancement of the contrast of the herniated disc, the sign of "hawk beak" or "point of beak" in the axial T2 view (compressed triangular image laterally along the cartilaginous border of the annulus fibrosus) [3,6]. The latter has been found by different authors (Liu CC-20118, Aprígio RM-20193, Thohar-Arifin M-20202) as in our study.
In 2001, Mut et al. Proposed a classification of intradural disc herniation into: Type A - intradural disc herniation and Type B disc herniation in the nerve root sheath, which can only be diagnosed intraoperatively [3].
In several case studies (Wasserstrom R-199310, Aprígio RM-20193) the presence of contrast enhancement in the form of a ring on MRI with gadolinium has been highlighted, which occurs as part of a process of peripheral neovascularization and chronic granulation, and allows to differentiate a spinal disc from infections or tumors. The finding of this sign in the MRI performed on our patient supported the presumptive diagnosis of IHD.
At present, it has been reported that the use of high-resolution 3D magnetic resonance imaging CISS (constructive interference in steady state) sequences allows to accurately represent HDI. This sequence should be taken into account when IHD is suspected to optimally guide the surgical approach in complex cases [6].
The main treatment of IHD is surgical and consists of the removal of the herniated disc material. The dura and nerve roots require special care and attention during the examination. Challenges in exploring the dura of the anterolateral segments represent a common problem. Thick adhesions between the disc and the dura have been reported at the time of surgery while the dural sac tends to be rough, tight, and immobile. For these reasons, the microsurgical approach through a median or paramedian dural incision is recommended for better visualization of the hernia, avoiding damage to the nerve roots, these can be minimally stimulated to prevent neurological dysfunction [2].
In the case presented, microsurgical extraction of the herniated disc was achieved, protecting the nerve structures involved and preserving the vertebral anatomy through D12-L1 laminoplasty.
Kim HS et al. Used a transforaminal endoscopic treatment in a patient with intradural disc herniation at the L2-L3 level, they achieved endoscopic excision of the intradural disc fragments through the original rupture in the anterolateral aspect of the dura mater, performed the sealing with dural patch and Gelfoam without the need for lumbar drainage. The clinical results obtained were positive after a follow-up of 8 months [4]. The extension of endoscopic surgery to this condition offers new therapeutic options today.
HDI should be included among intradural, extraxial spinal injuries, despite being a very low frequency entity. By means of the MRI study, a group of imaging signs that support the preoperative diagnosis of this lesion can be described. Surgery is the definitive therapeutic method and allows an accurate diagnosis of spinal herniation to be established.
The authors declare that they have no conflict of interest.
Clearly Auctoresonline and particularly Psychology and Mental Health Care Journal is dedicated to improving health care services for individuals and populations. The editorial boards' ability to efficiently recognize and share the global importance of health literacy with a variety of stakeholders. Auctoresonline publishing platform can be used to facilitate of optimal client-based services and should be added to health care professionals' repertoire of evidence-based health care resources.
Journal of Clinical Cardiology and Cardiovascular Intervention The submission and review process was adequate. However I think that the publication total value should have been enlightened in early fases. Thank you for all.
Journal of Women Health Care and Issues By the present mail, I want to say thank to you and tour colleagues for facilitating my published article. Specially thank you for the peer review process, support from the editorial office. I appreciate positively the quality of your journal.
Journal of Clinical Research and Reports I would be very delighted to submit my testimonial regarding the reviewer board and the editorial office. The reviewer board were accurate and helpful regarding any modifications for my manuscript. And the editorial office were very helpful and supportive in contacting and monitoring with any update and offering help. It was my pleasure to contribute with your promising Journal and I am looking forward for more collaboration.
We would like to thank the Journal of Thoracic Disease and Cardiothoracic Surgery because of the services they provided us for our articles. The peer-review process was done in a very excellent time manner, and the opinions of the reviewers helped us to improve our manuscript further. The editorial office had an outstanding correspondence with us and guided us in many ways. During a hard time of the pandemic that is affecting every one of us tremendously, the editorial office helped us make everything easier for publishing scientific work. Hope for a more scientific relationship with your Journal.
The peer-review process which consisted high quality queries on the paper. I did answer six reviewers’ questions and comments before the paper was accepted. The support from the editorial office is excellent.
Journal of Neuroscience and Neurological Surgery. I had the experience of publishing a research article recently. The whole process was simple from submission to publication. The reviewers made specific and valuable recommendations and corrections that improved the quality of my publication. I strongly recommend this Journal.
Dr. Katarzyna Byczkowska My testimonial covering: "The peer review process is quick and effective. The support from the editorial office is very professional and friendly. Quality of the Clinical Cardiology and Cardiovascular Interventions is scientific and publishes ground-breaking research on cardiology that is useful for other professionals in the field.
Thank you most sincerely, with regard to the support you have given in relation to the reviewing process and the processing of my article entitled "Large Cell Neuroendocrine Carcinoma of The Prostate Gland: A Review and Update" for publication in your esteemed Journal, Journal of Cancer Research and Cellular Therapeutics". The editorial team has been very supportive.
Testimony of Journal of Clinical Otorhinolaryngology: work with your Reviews has been a educational and constructive experience. The editorial office were very helpful and supportive. It was a pleasure to contribute to your Journal.
Dr. Bernard Terkimbi Utoo, I am happy to publish my scientific work in Journal of Women Health Care and Issues (JWHCI). The manuscript submission was seamless and peer review process was top notch. I was amazed that 4 reviewers worked on the manuscript which made it a highly technical, standard and excellent quality paper. I appreciate the format and consideration for the APC as well as the speed of publication. It is my pleasure to continue with this scientific relationship with the esteem JWHCI.
This is an acknowledgment for peer reviewers, editorial board of Journal of Clinical Research and Reports. They show a lot of consideration for us as publishers for our research article “Evaluation of the different factors associated with side effects of COVID-19 vaccination on medical students, Mutah university, Al-Karak, Jordan”, in a very professional and easy way. This journal is one of outstanding medical journal.
Dear Hao Jiang, to Journal of Nutrition and Food Processing We greatly appreciate the efficient, professional and rapid processing of our paper by your team. If there is anything else we should do, please do not hesitate to let us know. On behalf of my co-authors, we would like to express our great appreciation to editor and reviewers.
As an author who has recently published in the journal "Brain and Neurological Disorders". I am delighted to provide a testimonial on the peer review process, editorial office support, and the overall quality of the journal. The peer review process at Brain and Neurological Disorders is rigorous and meticulous, ensuring that only high-quality, evidence-based research is published. The reviewers are experts in their fields, and their comments and suggestions were constructive and helped improve the quality of my manuscript. The review process was timely and efficient, with clear communication from the editorial office at each stage. The support from the editorial office was exceptional throughout the entire process. The editorial staff was responsive, professional, and always willing to help. They provided valuable guidance on formatting, structure, and ethical considerations, making the submission process seamless. Moreover, they kept me informed about the status of my manuscript and provided timely updates, which made the process less stressful. The journal Brain and Neurological Disorders is of the highest quality, with a strong focus on publishing cutting-edge research in the field of neurology. The articles published in this journal are well-researched, rigorously peer-reviewed, and written by experts in the field. The journal maintains high standards, ensuring that readers are provided with the most up-to-date and reliable information on brain and neurological disorders. In conclusion, I had a wonderful experience publishing in Brain and Neurological Disorders. The peer review process was thorough, the editorial office provided exceptional support, and the journal's quality is second to none. I would highly recommend this journal to any researcher working in the field of neurology and brain disorders.
Dear Agrippa Hilda, Journal of Neuroscience and Neurological Surgery, Editorial Coordinator, I trust this message finds you well. I want to extend my appreciation for considering my article for publication in your esteemed journal. I am pleased to provide a testimonial regarding the peer review process and the support received from your editorial office. The peer review process for my paper was carried out in a highly professional and thorough manner. The feedback and comments provided by the authors were constructive and very useful in improving the quality of the manuscript. This rigorous assessment process undoubtedly contributes to the high standards maintained by your journal.
International Journal of Clinical Case Reports and Reviews. I strongly recommend to consider submitting your work to this high-quality journal. The support and availability of the Editorial staff is outstanding and the review process was both efficient and rigorous.
Thank you very much for publishing my Research Article titled “Comparing Treatment Outcome Of Allergic Rhinitis Patients After Using Fluticasone Nasal Spray And Nasal Douching" in the Journal of Clinical Otorhinolaryngology. As Medical Professionals we are immensely benefited from study of various informative Articles and Papers published in this high quality Journal. I look forward to enriching my knowledge by regular study of the Journal and contribute my future work in the field of ENT through the Journal for use by the medical fraternity. The support from the Editorial office was excellent and very prompt. I also welcome the comments received from the readers of my Research Article.
Dear Erica Kelsey, Editorial Coordinator of Cancer Research and Cellular Therapeutics Our team is very satisfied with the processing of our paper by your journal. That was fast, efficient, rigorous, but without unnecessary complications. We appreciated the very short time between the submission of the paper and its publication on line on your site.
I am very glad to say that the peer review process is very successful and fast and support from the Editorial Office. Therefore, I would like to continue our scientific relationship for a long time. And I especially thank you for your kindly attention towards my article. Have a good day!
"We recently published an article entitled “Influence of beta-Cyclodextrins upon the Degradation of Carbofuran Derivatives under Alkaline Conditions" in the Journal of “Pesticides and Biofertilizers” to show that the cyclodextrins protect the carbamates increasing their half-life time in the presence of basic conditions This will be very helpful to understand carbofuran behaviour in the analytical, agro-environmental and food areas. We greatly appreciated the interaction with the editor and the editorial team; we were particularly well accompanied during the course of the revision process, since all various steps towards publication were short and without delay".
I would like to express my gratitude towards you process of article review and submission. I found this to be very fair and expedient. Your follow up has been excellent. I have many publications in national and international journal and your process has been one of the best so far. Keep up the great work.
We are grateful for this opportunity to provide a glowing recommendation to the Journal of Psychiatry and Psychotherapy. We found that the editorial team were very supportive, helpful, kept us abreast of timelines and over all very professional in nature. The peer review process was rigorous, efficient and constructive that really enhanced our article submission. The experience with this journal remains one of our best ever and we look forward to providing future submissions in the near future.
I am very pleased to serve as EBM of the journal, I hope many years of my experience in stem cells can help the journal from one way or another. As we know, stem cells hold great potential for regenerative medicine, which are mostly used to promote the repair response of diseased, dysfunctional or injured tissue using stem cells or their derivatives. I think Stem Cell Research and Therapeutics International is a great platform to publish and share the understanding towards the biology and translational or clinical application of stem cells.
I would like to give my testimony in the support I have got by the peer review process and to support the editorial office where they were of asset to support young author like me to be encouraged to publish their work in your respected journal and globalize and share knowledge across the globe. I really give my great gratitude to your journal and the peer review including the editorial office.
I am delighted to publish our manuscript entitled "A Perspective on Cocaine Induced Stroke - Its Mechanisms and Management" in the Journal of Neuroscience and Neurological Surgery. The peer review process, support from the editorial office, and quality of the journal are excellent. The manuscripts published are of high quality and of excellent scientific value. I recommend this journal very much to colleagues.
Dr.Tania Muñoz, My experience as researcher and author of a review article in The Journal Clinical Cardiology and Interventions has been very enriching and stimulating. The editorial team is excellent, performs its work with absolute responsibility and delivery. They are proactive, dynamic and receptive to all proposals. Supporting at all times the vast universe of authors who choose them as an option for publication. The team of review specialists, members of the editorial board, are brilliant professionals, with remarkable performance in medical research and scientific methodology. Together they form a frontline team that consolidates the JCCI as a magnificent option for the publication and review of high-level medical articles and broad collective interest. I am honored to be able to share my review article and open to receive all your comments.
“The peer review process of JPMHC is quick and effective. Authors are benefited by good and professional reviewers with huge experience in the field of psychology and mental health. The support from the editorial office is very professional. People to contact to are friendly and happy to help and assist any query authors might have. Quality of the Journal is scientific and publishes ground-breaking research on mental health that is useful for other professionals in the field”.
Dear editorial department: On behalf of our team, I hereby certify the reliability and superiority of the International Journal of Clinical Case Reports and Reviews in the peer review process, editorial support, and journal quality. Firstly, the peer review process of the International Journal of Clinical Case Reports and Reviews is rigorous, fair, transparent, fast, and of high quality. The editorial department invites experts from relevant fields as anonymous reviewers to review all submitted manuscripts. These experts have rich academic backgrounds and experience, and can accurately evaluate the academic quality, originality, and suitability of manuscripts. The editorial department is committed to ensuring the rigor of the peer review process, while also making every effort to ensure a fast review cycle to meet the needs of authors and the academic community. Secondly, the editorial team of the International Journal of Clinical Case Reports and Reviews is composed of a group of senior scholars and professionals with rich experience and professional knowledge in related fields. The editorial department is committed to assisting authors in improving their manuscripts, ensuring their academic accuracy, clarity, and completeness. Editors actively collaborate with authors, providing useful suggestions and feedback to promote the improvement and development of the manuscript. We believe that the support of the editorial department is one of the key factors in ensuring the quality of the journal. Finally, the International Journal of Clinical Case Reports and Reviews is renowned for its high- quality articles and strict academic standards. The editorial department is committed to publishing innovative and academically valuable research results to promote the development and progress of related fields. The International Journal of Clinical Case Reports and Reviews is reasonably priced and ensures excellent service and quality ratio, allowing authors to obtain high-level academic publishing opportunities in an affordable manner. I hereby solemnly declare that the International Journal of Clinical Case Reports and Reviews has a high level of credibility and superiority in terms of peer review process, editorial support, reasonable fees, and journal quality. Sincerely, Rui Tao.
Clinical Cardiology and Cardiovascular Interventions I testity the covering of the peer review process, support from the editorial office, and quality of the journal.
Clinical Cardiology and Cardiovascular Interventions, we deeply appreciate the interest shown in our work and its publication. It has been a true pleasure to collaborate with you. The peer review process, as well as the support provided by the editorial office, have been exceptional, and the quality of the journal is very high, which was a determining factor in our decision to publish with you.
The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews journal clinically in the future time.
Clinical Cardiology and Cardiovascular Interventions, I would like to express my sincerest gratitude for the trust placed in our team for the publication in your journal. It has been a true pleasure to collaborate with you on this project. I am pleased to inform you that both the peer review process and the attention from the editorial coordination have been excellent. Your team has worked with dedication and professionalism to ensure that your publication meets the highest standards of quality. We are confident that this collaboration will result in mutual success, and we are eager to see the fruits of this shared effort.
Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, I hope this message finds you well. I want to express my utmost gratitude for your excellent work and for the dedication and speed in the publication process of my article titled "Navigating Innovation: Qualitative Insights on Using Technology for Health Education in Acute Coronary Syndrome Patients." I am very satisfied with the peer review process, the support from the editorial office, and the quality of the journal. I hope we can maintain our scientific relationship in the long term.
Dear Monica Gissare, - Editorial Coordinator of Nutrition and Food Processing. ¨My testimony with you is truly professional, with a positive response regarding the follow-up of the article and its review, you took into account my qualities and the importance of the topic¨.
Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, The review process for the article “The Handling of Anti-aggregants and Anticoagulants in the Oncologic Heart Patient Submitted to Surgery” was extremely rigorous and detailed. From the initial submission to the final acceptance, the editorial team at the “Journal of Clinical Cardiology and Cardiovascular Interventions” demonstrated a high level of professionalism and dedication. The reviewers provided constructive and detailed feedback, which was essential for improving the quality of our work. Communication was always clear and efficient, ensuring that all our questions were promptly addressed. The quality of the “Journal of Clinical Cardiology and Cardiovascular Interventions” is undeniable. It is a peer-reviewed, open-access publication dedicated exclusively to disseminating high-quality research in the field of clinical cardiology and cardiovascular interventions. The journal's impact factor is currently under evaluation, and it is indexed in reputable databases, which further reinforces its credibility and relevance in the scientific field. I highly recommend this journal to researchers looking for a reputable platform to publish their studies.
Dear Editorial Coordinator of the Journal of Nutrition and Food Processing! "I would like to thank the Journal of Nutrition and Food Processing for including and publishing my article. The peer review process was very quick, movement and precise. The Editorial Board has done an extremely conscientious job with much help, valuable comments and advices. I find the journal very valuable from a professional point of view, thank you very much for allowing me to be part of it and I would like to participate in the future!”
Dealing with The Journal of Neurology and Neurological Surgery was very smooth and comprehensive. The office staff took time to address my needs and the response from editors and the office was prompt and fair. I certainly hope to publish with this journal again.Their professionalism is apparent and more than satisfactory. Susan Weiner
My Testimonial Covering as fellowing: Lin-Show Chin. The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews.
My experience publishing in Psychology and Mental Health Care was exceptional. The peer review process was rigorous and constructive, with reviewers providing valuable insights that helped enhance the quality of our work. The editorial team was highly supportive and responsive, making the submission process smooth and efficient. The journal's commitment to high standards and academic rigor makes it a respected platform for quality research. I am grateful for the opportunity to publish in such a reputable journal.
My experience publishing in International Journal of Clinical Case Reports and Reviews was exceptional. I Come forth to Provide a Testimonial Covering the Peer Review Process and the editorial office for the Professional and Impartial Evaluation of the Manuscript.
