摘要:

Pathophysiologically, nerve root pain production is a complex issue. For many years, mechanical compression has been regarded as the sole cause for such pain. There are indications, however, that other factors, such as intraneural inflammation, may be of importance in this context. In this article, four cases are presented in which nerve root related pain gradually resolved without any proven change in the mechanical deformation of the involved nerve root. The data presented here suggest that mechanical compression, per se, may not always be the sole cause of radicular pain and dysfunction. These findings suggest that improvement is needed in our understanding of the pathophysiology of nerve root compression and inflammation]

ISSN:0362-2436    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

Several authors have previously reported the complications resulting from contact between a diagnostic or therapeutic agent injected into an intervertebral disc and neural tissue. This study was undertaken to demonstrate the common routes by which, and frequency with which this contact occurs. Of 105 cadaveric intervertebral discs studies, 15 (14%) leaked. Of the discs that leaked, 27% demonstrated contact of injected dye with the adjacent spinal nerve. The high rate of leakage may be related to the age of the cadavers. Nonetheless, the contact between substances injected into an intervertebral disc and adjacent neural tissue during discography offers an alternate mechanism of pain reproduction in an incompetent disc. It also suggests that nontoxic agents should be used for discography and that intervertebral discs should be proved competent before chemonucleolysis]

ISSN:0362-2436    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

Twenty-six patients (13 men and 13 women), ranging in age from 38 to 75 years, with surgical andlor radiculographic evidence of chronic adhesive spinal arachnoiditis (CASA) were admitted to a randomly allocated, doubleblind, 6-month crossover trial of d-penicillamine (500 mglday) versus matching placebo. Assessments using subjective and objective criteria at 3-month intervals demonstrated no statistically significant effect with either d-penicillamine or placebo or between them. Thirteen of the 17 patients completing the trial expressed no clear preference. One patient preferred placebo. The remaining three patients who expressed strong preference for dpenicillamine (supported by objective data) subsequently maintained improvement on long-term therapy for up to 5 years. It is concluded that there may be a small subgroup of patients with CASA who might benefit from d-penicillamine therapy]

ISSN:0362-2436    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

The properties of the omentum and its effect on spinal neurologic disease was investigated. Omental pedicle grafts were transferred to the laminectomized lumbar spines of nine neurologically normal dogs. Grafts were placed on either the dura or the spinal cord. Interruption of the graft's circulation was examined. To study the effect, the artery of the graft was injected with contrast and the graft-dura interface studied histologically. All injected specimens demonstrated vascular connections from the graft to the neural elements. The graft was found to decrease postoperative perineural scarring. The omentum appears to possess properties that could be applied to improve outcomes in spinal surgery]

ISSN:0362-2436    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

In each of eight thoracolumbar human cadaveric vertebrae, a hole was made through one pedicle into the vertebral body with a drill bit and through the contralatera1 pedicle with a probe. Identical metal screws were implanted into the holes to equal depths, and maximum pull-out force was determined for each screw. Using a paired Student t test, no significant difference (P = 0.87) was found in pull-out strength between the screws implanted into drilled holes and those implanted into probed holes. In fact, the average pull-out strengths for the two groups differed by less than 2%. The pedicular cortex was broken through during hole preparation in 5 of the 16 pedicles: 3 as a result of drilling and 2 secondary to probing. The average pull-out strength of the screws in these five pedicles was 11.0% less than the average pull-out strength of the screws implanted into the contralateral intact pedicles. Although this does not represent a statistically significant difference (P = 0.15), it suggests that damaging the pedicular cortex may weaken pedicle screw fixation]

ISSN:0362-2436    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

Cases of lumbar pedicle stress fractures are described and the term “pediculolysis” introduced. The condition may be bilateral or, more commonly, may occur in association with contralateral spondylolysis. A method of direct repair with pedicle screw fixation is described]

ISSN:0362-2436    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

lntradiscal gas collection, causing the radiographic vacuum phenomenon, is a common finding on radiographic studies of the lumbar spine. Four cases of radiographically documented and surgically confirmed cases of herniated discs containing gas are presented. All four patients presented with radicular symptoms secondary to the gas-containing herniations. Minimal nuclear material was found at surgery; however, all patients experienced relief after the operation.

ISSN:0362-2436    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

The usefulness of indium-111 white blood cell (WBC) scintigraphy in the detection of spine sepsis was studied in 22 patients who had open or percutaneous biopsies for microbiologic diagnosis. The indium images in 18 patients with vertebral infection were falsely negative in 15 (83%) and truly positive in 3 (17%). All four patients with negative cultures and histology had true-negative scans. The indium-1 11 WBC imaging results yielded a sensitivity of 17%, a specificity of 1 OO%, and an accuracy rate of 31%. Prior antibiotic therapy was correlated with a high incidence of false-negative.scans and photon-deficient indium- 1 11 WBC uptake. The usefulness of indium-1 11 WBC scintigraphy for the diagnosis of vertebral infection may be limited to those patients who have not been treated with antibiotics previously]

ISSN:0362-2436    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

The nucleotome, a recently developed instrument for percutaneous disc excision, was used for suction aspiration in two cases of osteomyelitis of the spine. The technique obtained significant amounts of pus, serosanguinous material, and tissue, which provided adequate samples for histologic examination and culture. Both patients obtained immediate relief of pain after a significant amount of pus and infected material was removed. Appropriate antibiotics were used for subsequent control of the infections. The riskand morbidity of this technique are no greater than with conventional needle biopsy.

ISSN:0362-2436    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

The nucleolytic action of chondroitinase ABC was studied by the use of rabbit lumbar intervertebral discs. The injection of one unit of enzyme results in necrosis of the nucleus pulposus. Radiologic, histologic, and biochemical changes were evident in discs studied 2 days after injection, and consistent nucleolysis was seen in those studied after 6 days. These results show that chondroitinase ABC deserves further evaluation as a possible chemonucleolytic enzyme]

ISSN:0362-2436    

出版商:OVID    

年代:1991

数据来源: OVID