摘要:

To test the repeatability of information about low-back pain elicited by self-administered questionnaire, histories obtained from 225 men and women were compared at an interval of 12 months. There was good agreement on whether subjects had ever suffered low-back pain (K = 0.82) and on whether the pain had ever led to consultation with a general practitioner (K = 0.76) or absence from work (K = 0.76). Information about the speed of onset of symptoms as well as histories of associated sciatica and disability for everyday activities were less reproducible. Epidemiologic studies based on such data must be interpreted with appropriate caution.

ISSN:0362-2436    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

In chemonucleolysis, accuracy of injection can be in doubt if the patient fails to respond. Discography preceding chemonucleolysis is associated with increased neurologic complications. Biplane fluoroscopy may fail to provide a clear picture on many occasions. The serum keratan sulphate levels were estimated in patients undergoing chemonucleolysis to ascertain if this could be used as a biochemical indicator to confirm accurate needle placement and to predict outcome. Serum keratan sulphate levels rose significantly following chemonucleolysis during the first 3 days (P<0.01). The rise was not significantly different, however, in patients who had improvement in their leg pain from those who did not improve (P= 0.35). Serum keratan sulphate level estimation before chemonucleolysis and at 24 or 48 hours following the procedure can be used to confirm accuracy of needle placement, but the rise in keratan sulphate is not predictive of the clinical outcome of the procedure.

ISSN:0362-2436    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

Vertebral column allografts, with their intervertebral discs, were implanted into thoracic spine defects (T7-T9) in 11 dogs in an attempt to re-establish spinal stability and preserve spinal biomechanics. Before implantation, the allografts were harvested under sterile conditions from similar-sized dogs and deep frozen at -80C. The animals were followed for 18 months postoperatively. Radiographs demonstrated gradual loss of intervertebral disc height. Biomechanical analysis showed that the dogs with allografts had no significant difference in spine stiffness compared with normal spines in compression, flexion, and extension testing. Control spines that had been fused were significantly stiffer than the allograft spines in all modes tested (P <0.05). Histologic analysis showed incorporation of the allograft but with incomplete revascularization of the allograft's eighth thoracic body. This investigation found that vertebral body allografts with intervertebral discs can function successfully for 18 months in a canine model. This research may assist in the development of physiologic treatment for spinal deficiencies in humans.

ISSN:0362-2436    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

This study was done to establish the relevance of axial rotation as a cause of disc degeneration in the lumbar spine and the role of facet asymmetry in the injury mechanism. It previously was shown that facet asymmetry does not affect the axial torque-rotation response of lumbar motion segments. This study, in both an experimental and a finite-element analysis, examined three important points previously not considered for lumbar motion segments subjected to axial torque: 1) the effect of facet asymmetry on the coupled motions; 2) the effect of combined geometric parameters on the segment response; and 3) the effect of facet asymmetry on the annular strains. Three different lumbar-coupling patterns were observed; however, they did not appear to be influenced by facet joint asymmetry. An oblique and flat compression facet may allow an increased motion-segment response, but in general, combined geometric parameters were found to have no effect on segment response. It was concluded that, without facet damage, the right or left side of the disc is not biased by a particular facet geometry to experience unusual levels of stress and strain, either as a result of increased axial rotation or any of the associated coupled motions.

ISSN:0362-2436    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

This study was done to assess the interplay between muscular and ligamentous sources of extensor moment during dynamic lifting with various loads and flexion angles of the trunk segment for 15 subjects lifting a total of 150 loads. Ligament forces predicted from an anatomically detailed biomechanical model did not generally contribute more than 60 Nm for most of the lifts because the lumbar spine was only flexed to a moderate and constant degree for each load condition. In contrast, additional moment demands associated with increases in hand load were supported by muscle. Although the compression forces on the L4-5 intervertebral disc were fairly insensitive to the interplay between the recruitment of muscle and ligament, the shear force was significantly higher with a greater degree of lumbar flexion. The risk of injury may be influenced more by the degree of lumbar flexion than the choice of stoop or squat technique.

ISSN:0362-2436    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

Effects of subject positions on range and repeatability of thoracic and lumbar forward flexion, extension, and lateral flexion were studied. Inclinometric methods were used, and 27 subjects were measured by two trained testers. No great differences in repeatability and range of movements were found between measurements in different positions, but according to the results and convenience of performance, the following positions could be recommended: forward flexion in a sitting position, extension while lying on an examination table with arms braced ahead, and lateral flexion close to a wall and facing it.

ISSN:0362-2436    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

The sacroiliac joints of seven pelvic specimens were examined to determine functional, morphologic, and histopathologic aspects. The movements were measured in four intact pelvises (from two men and two women). The joint surfaces of all pelvises (from three men and four women) then were examined topographically by means of a photogrammetric method. After this, they were examined histologically to characterize any effects on function. The morphologic investigation revealed sex-specific differences. All joint surfaces from the female pelvises showed circular contours, the centers of which coincided with the iliac tuberosities. These morphologic characteristics were not discernible in the joint surfaces from the male pelvises; these had interlocking irregularities without a topographic pattern. As expected, this configuration involved distinct differences in mobility. Rotation of the sacrum was markedly less in the sacroiliac joints of men than in those of women.

ISSN:0362-2436    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

From 1984 to 1987, nine patients with posterior lumbar apophyseal fracture underwent surgery. The clinical pattern was characterized by vertebral rigidity and leg pain in all cases, with associated nerve root deficit in three cases, neurogenic claudication in one, and paraparesis in one. In all patients, treatment consisted of removal of a bony and/or cartilaginous fragment. In eight patients, it was done through a posterior approach (unilateral laminotomy with partial f acetectomy in six cases and bilateral laminectomy in two) and in one with paraparesis by means of hemicorporectomy followed by anterior fusion. At follow-up (minimum, 2 years), all patients showed complete regression of the painful symptoms, with a total recovery in cases with neurologic problems. The only complication was an incomplete cauda syndrome; this appeared immediately after the operation and regressed completely with conservative treatment after 6 months.

ISSN:0362-2436    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

The incidence of thoracic scoliosis after completion of growth was studied in a group of patients operated on in childhood with a lateral thoracotomy for esophageal atresia and cardiac and pulmonary disorders. Twenty of 61 patients had a thoracic scoliosis exceeding 10°. The curves were mostly convex toward the operated side except in patients treated surgically for esophageal atresia, in which they were concave toward the operated side. None of the curves exceeded 25°, and no therapy was needed. Thoracic scoliosis should, however, be remembered as a possible complication after lateral thoracotomy in childhood.

ISSN:0362-2436    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

An examination of the transverse plane aspect of deformed vertebrae from specimens of both human and animal scoliosis identified a consistent pattern of intravertebral deformity. In the animal model, dynamic bone growth studies illustrated bone drift in the opposite direction to the rotation of the scoliosis, suggesting that the bone growth in the transverse plane was attempting to correct rather than produce the deformity. The observed pattern of vertebral deformity can be explained in simple terms because it obeys the standard laws of bone growth and remodeling. This observed growth pattern is consistent only with the production of idiopathic scoliosis by the rotation of a primary lordosis.

ISSN:0362-2436    

出版商:OVID    

年代:1991

数据来源: OVID