摘要:

Four cases of vascular complications to anterior perforations during discectomy prompted a CT study to measure lumbar disc diameters and to evaluate the prevertebral anatomy. Fifty young adults who had been referred for low-back pain and/or sciatica but had not undergone operation were included. In five additional patients, prone versus supine CT examinations were compared. Six typical configurations of the vascular anatomy could be classified to explain the type of vascular complications occurring at the L3–4 and L4–L5 disc levels. The sagittal diameter of the three lowest lumbar discs varied from 33 to 56 mm, indicating the importance of this parameter as an intraoperative guideline for the spine surgeon. Airfilled intestines were observed anterior to the L5–S1 disc predominantly in the prone position. The possible relationship between this finding and postoperative discitis is discussed.

ISSN:0362-2436    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

Nerve root compression has been suggested as one important pathogenetic factor in low-back pain syndromes and sciatica. The underlying pathophysiologic mechanisms are, however, incompletely known, partly because of the lack of experimental data on this topic. In the present study, a model for experimental compression of the porcine sacrococcygeal cauda equina is presented. The model consists of surgical exposure of the cauda equina and compression of the cauda equina toward the ventral aspect of the spinal canal by an inflatable balloon fixed to the spine. This compression system was shown to have a high accuracy in pressure transmission from the balloon to the cauda equina. The gross and microscopic neural anatomy and the vascujar anatomy of the porcine cauda equina were analyzed with light microscopic and ink-perfusion techniques. The porcine cauda equina showed a close anatomic resemblance to the human lumbosacral cauda equina. The presented model offers unique possibilities for experimental studies on nerve root compression injury because of the easy surgical exposure and the sufficient length of the nerve roots. In separate studies, this model, along with investigations of solute transport to the nerve tissue and of impulse propagation, has been used to analyze the effects of acute, graded compression on blood flow and edema formation in the cauda equina. The porcine cauda equina would also be particularly suitable for chronic compression studies because any neurologic deficit acquired would be restricted to the tail.

ISSN:0362-2436    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

Between July 1983 and November 1986, 29 patients with thoracolumbar burst fractures underwent a one-stage operation consisting of anterior decompression by subtotal vertebrectomy, reduction, and stabilization with the Slot–Zielke device. The mean follow-up was 3.1 years. Most patients with incomplete neurologic lesions showed postoperative improvement and were upgraded one or two steps in the Frankel scale. No patient showed neurologic deterioration after surgery. In all patients, bony union occurred. Loss of reduction of more then 5° occurred in 41% of the patients. Because of this high rate of loss of reduction in patients and the low degree of flexionbending loading and torsional stability in biomechanical evaluationin vitroof the Slot-Zielke device on human cadaveric spines, in additional posterior stabilization of the spine after an anterior approach for anterior-and middle-column fractures should be considered.

ISSN:0362-2436    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

Ninety-eight patients with traumatic spinal cord injury, at a median age of 33.5 years (range, 16–72 years), with nonremarkable distributions of neurologic characteristics were investigated at a median of 2.3 years (range, 0.1–23 years) after injury. Functioning, mood disturbances, and overall quality of life were recorded with established self-assessment instruments. Physical dysfunction levels were moderate, being proportionate to neurologic impairment. Psychosocial functions, mood states, and quality-of-life perceptions did not differ from those of a control population sample. Psychosocial function and mood disturbances varied greatly during the first 4 years after injury, but patients' later recordings expressed predominantly a balanced emotional state and a rewarding social life. Progress in this direction consisted of clearly lessened physical dysfunction 1 year after injury and better psychosocial function and well-being after 2 years, whereas patterns of social activities and contacts became gradually less inhibited during a 4-year period after injury. Analysis of complications in patients' histories that affected function and mood showed severe pain to be the only complication that related to lower quality-of-life scores. Urinary incontinence and infection and autonomous dysref lexia related to inhibited self-care performance; spasticity related to impaired ambulation and feeding skills. Gainful employment was the only demographic factor linked to high quality-of-life scores

ISSN:0362-2436    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

This report investigates dimensions of hand and foot preference in 159 girls with idiopathic scoliosis diagnosed after the age of 8 years, 1,522 girls with clinically straight spines, and 132 with minor truncal asymmetry. It was found that, although there was no significant difference in hand or foot preference for individual items between scoliotic groups and controls, there was a statistically significant tendency for children with any degree of asymmetry to show uniform lateralization in the sense of consistency of side preference. Another, smaller group showed a tendency for scoliosis to be associated with clearly visible facial asymmetry, which itself correlated with handedness. It was concluded that theories of scoliosis need to include the frequently ignored minor observations, such as the well-known fact of lateralization of the curve, if they are to describe the condition completely. Because the asymmetry of cerebral lateralization is known to be genetically determined and because it is thought to result in other skeletal asymmetries, such as skull and limb inequality, it seemed reasonable to investigate the primary cause of that gross asymmetry, idiopathic scoliosis.

ISSN:0362-2436    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

All 813 patients with idiopathic scoliosis who completed their first Schroth physiotherapeutic rehabilitation program at the Katharina Schroth Hospital between 1984 and 1987 were reviewed. The patients were divided into four age groups. In Group I (10–13 years, N = 278), vital capacity in patients treated for the first time improved by 18.94% (445 ml). In Group II (14–17 years, N = 264), the average increase in vital capacity after initial treatment was 16.33% (497 ml). In Groups III (18–24 years, N = 123) and IV (> 24 years, N = 148), the corresponding increases were 15.11% (501) and 13.77% (394 ml), respectively. In the 256 patients receiving repeat treatment, the increases in vital capacity in the respective age groups amounted to just more than half those in the patients treated for the first time. The average increase in chest expansion was more than 20% in all groups at all measuring points. These findings show that a course of inpatient treatment by the Schroth method can lead to an increase in vital capacity and chest expansion so that, even in adult scoliosis patients, effective treatment of the associated restrictive ventilatory disorder is possible.

ISSN:0362-2436    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

Clinically significant respiratory failure in a group of animals with an experimentally produced structural thoracic scoliosis was identified. A detailed physiologic investigation of their respiratory function showed that their respiratory compromise was associated with the development of a smaller and stiffer chest. Frank respiratory failure, however, was rare and seen only in animals with the most severe spinal deformities when it was also associated with a general failure to thrive. Animals with less severe deformities had little measurable restriction of pulmonary function, did not develop respiratory failure, and grew normally.

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