摘要:

Lumbar intervertebral disc herniation is thought to be related to senescent changes in the nucleus pulposus except in rare instances of trauma. This investigation provides the firstin vitromodel of disc prolapse that reliably ruptures discs under physiologically reasonable stress. Fourteen vertebral motion segments with intact posterior elements were loaded repetitively at 1.5 Hz in a combination of flexion (7°), rotation (< 3°), and compression (1,334 N) for an average of 6.9 hours (range, 3.0–13.0 hours) in a materials testing machine. Loading was terminated when reaction force leveled off for more than 1 hour. Ten discs failed through annular protrusions, and four failed by nuclear extrusion through annular tears, supporting the hypothesis that intervertebral disc prolapse is peripheral in origin. The annulus fibrosus is the site of primary pathologic change.

ISSN:0362-2436    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

Of 66 nonoperated low-back pain patients who entered a 4-week program of modern active rehabilitation after 13 months' sick leave, only 15 (23%) had returned to work at 18 months' follow-up. Effective pain modulation with pool traction did not influence the vocational status or pain level at the time of follow-up. The prevalence of blue-collar workers among the clients were doubled compared with the general population, and a high proportion were unskilled (71%). It is concluded that the resources of health services should be used in the subacute stage to produce an earlier and more precise organic and psychosocial diagnosis and to state the preference of an active attitude supported by general physical training.

ISSN:0362-2436    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

A study to determine the feasibility of measurement of conduction velocities through the lumbosacral nerve roots by direct percutaneous stimulation of the cauda equina is reported. The technique was applied to a series of normal volunteers and its reliability and reproducibility confirmed. An electrophysiologic defect was demonstrated in most patients with surgically proven lateral recess stenosis. Electrophysiologic recovery was shown in patients examined after surgery, Although the technique can be refined, these early results are encouraging.

ISSN:0362-2436    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

End-to-end anastomoses were done between the motor roots of T12 and T13 intercostal nerves and the ipsilateral transsected L1 lumbar nerve in four dogs. In three of the dogs, the clinical and electrophysiologic findings showed functional viability of the intercostolumbar anastomosis 3.5 months after the anastomosis was done. The method may be practical for reinnervating an injured lumbar nerve with two intercostal nerves or to bypass a spinal cord lesion.

ISSN:0362-2436    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

Thirty-four patients with traumatic distractive flexion injuries in the mid to lower cervical spine were treated with posterior wire stabilization without bony fusion from January 1981 through May 1987. Fifteen had cord involvement, and nine had root involvement. Ten were neurologically intact. Thirty patients were followed for a mean of 38 months. Two neurologically intact patients had root deficits postoperatively. One patient was reoperated because of redislocation due to a spinous process fracture. Mean loss of lordosis was 7.5°, Eight patients had a wire break at follow-up, but no case of late instability was observed. Sixteen patients had signs of spontaneous anterior inter-body fusion at follow-up, and 11 patients had signs of posterior fusion. Twenty-four patients complained of late—but in most cases—minor pain. These results indicate that simple posterior wiring without bony fusion is a reliable method to obtain good immediate stability in traumatic distractive flexion injuries of the mid to lower cervical spine. The wires provide sufficient stability during the time of soft tissue healing.

ISSN:0362-2436    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

The diagnostic values of the presence of Virchow's node (VN) or rectal shelf (RS) in spinal metastasis from adeno-carcinoma of unknown origin were studied prospectively in 60 patients during 1986–1988. These were compared with 14 cases with other malignancies of the spine and 37 controls with nonneoplastic spinal lesions. The diagnosis was confirmed by histologic study in all malignant cases. The results were analyzed by diagnostic test analysis and McNemar X, testing. This yields 18.3–21.6%, 97.2–100%, and 92.8–100% sensitivity, specificity, and predictive value, respectively, for a positive test for VN and RS to differentiate significantly adenocarcinoma from other malignancies and control patients (P< 0.005). These findings may thus be considered as a simple and economic guide for physicians to determine the proper approach to patients with a spinal lesion suspected to be malignant.

ISSN:0362-2436    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

The description of the peripheral course of the greater occipital nerve (GON) varies in the literature. An autopsy study was done on 20 cases without known headache problems. These findings showed a marked variation in the relation between the GON and nuchal muscles. The trapezius muscle was penetrated by the GON in 45% of cases, the semispinal muscle of the head was penetrated in 90% of cases, and the inferior oblique muscle of head was penetrated in 7.5% of cases. Macroscopic findings of possible compression were made in 11 cases (27.5%), indicating that nerve compressionper semay be of minor importance since it seems to exist in the absence of headache.

ISSN:0362-2436    

出版商:OVID    

年代:1991

数据来源: OVID

ISSN:0362-2436    

出版商:OVID    

年代:1991

数据来源: OVID

ISSN:0362-2436    

出版商:OVID    

年代:1991

数据来源: OVID

ISSN:0362-2436    

出版商:OVID    

年代:1991

数据来源: OVID