摘要:

In repeat lumbar surgery for failure of the original operation to provide lasting relief, well-organized fibrous tissue is often noted binding together the dura, nerve roots, and erector spinae muscles. Lumbar laminectomy was carried out in 46 dogs and seven groups of animals studied. Gelfoam failed to prevent fibrosis. Free fat grafts prevented fibrosis whether the graft was placed at the laminectomy site or around the nerve roots. Vascularization of the grafts was demonstrated by injection of India ink before sacrifice. Ligamentum nuchae, which is similar to ligamentum flavum in its high elastic content, was also effective in preventing scar formation. The operative biopsy findings at reexploration in four patients who had free fat grafts following laminectomy are presented.

ISSN:0362-2436    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

A clinical test designed to help differentiate neurologic from axial back and leg pain is described. The prone knee-flexion provocative test produces or enhances reflex suppression and/or motor weakness secondary to intervertebral disc protrusion. The pathophysiology of this test depends on compression of the spinal nerves, which may occur from a combination of biomechanical factors secondary to lumbar spinal extension. Because this maneuver is required to demonstrate evidence of neural compression, the pathologic condition of the disc is probably mild to moderate and therefore should respond to conservative therapy.

ISSN:0362-2436    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

Selective lumbosacral radiculography and block was performed on 106 patients, using 60% Conray or Dimer-X and 1% lidocaine mixed with corticosteroid. The technique of this method is reported, and the radiculographic findings and diagnostic value of this method are discussed. According to our experience, this method is technically simple and very useful in determining the limit of the lumbosacral nerve root lesion, and occasionally can be used to relieve radicular symptoms. We think it is an especially excellent diagnostic technique for disorders featuring nerve root entrapment in the lateral foraminal recess, in which accurate localization cannot be determined by the other auxiliary diagnostic measures.

ISSN:0362-2436    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

Three hundred four consecutive patients with low-back pain were given epidural anesthetic and steroid injections. A prospective study demonstrated that selected patients had 87% short-term success and 34% relief of pain for as long as 6 months. No patient was cured by these injections. Needle placement during epidural injections was incorrect 25% of the time in experienced hands.

ISSN:0362-2436    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

The failures and poor results of lumbar spine surgery are analyzed in a retrospective study of 105 consecutive patients referred to the authors for evaluation during 1976. Those who had a history of industrial or vehicular accident outnumbered others by about two to one. Review of histories, physical findings, and myelograms in most of the patients failed to substantiate the diagnosis of ruptured disc or nerve root compression. Many of the failures occurred in those patients in whom little if any evidence of nerve root compression was found. The indications for surgery were poor in this group. Other failures occurred in patients who had improper, incomplete, or inadequate operations, especially those with lumbar spondylosis, a retained fragment of disc, or surgery at the wrong level. In addition to failures, poor results were recorded in patients who had significant nerve root or cauda equina injury from surgery, associated “arachnoiditis“ which is thought to result from surgical trauma in many instances, or multiple operations leading to a hopelessly disabled state.

ISSN:0362-2436    

出版商:OVID    

年代:1980

数据来源: OVID