摘要:

Three cases of seizures and marked behavioral changes that occurred after intrathecal metrizamide administration are reported. In each case a cranial computed tomographic scan obtained within 24 hours of the ictus showed hyperdensity of the gray matter, and created an optical illusion of diffuse white matter edema. The literature on adverse reactions and their pathogenesis and on brain parenchymal penetration of metrizamide is reviewed.

ISSN:0362-2436    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

A new program (3D83, General Electric) was used to reformat three-dimensional (3D) images from two-dimensional (2D) computed tomographic axial scans in 18 patients who had routine scans of the spine. The 3D spine images were extremely true to life and could be rotated around all three principle axes (constituting a movie), so that an illusion of head-motion parallax was created. The benefit of 3D reformation with this program is primarily for preoperative planning. It appears that 3D can also effectively determine the patency of foraminal stenosis by reformatting in hemisections. Currently this program is subject to several drawbacks that require user interaction and long reconstruction time. With further improvement, 3D reformation will find increasing clinical applicability.

ISSN:0362-2436    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

The purpose of this study was to determine the incidence and severity of degenerative changes seen on lateral roentgenograms in 200 asymptomatic men and women in five age groups with an age range of 20-65 years and to determine the normal values of cervical lordosis and spinal canal sagittal diameters and their relationship to degenerative changes. It was found that by age 60-65,95% of the men and 70% of the women had at least one degenerative change on their roentgenograms. A small sagittal diameter correlated with the presence of degenerative changes at the same disc level, and the strongest correlation was with the size of the posterior osteophytes at C5-6 (r = 0.52) Cervical lordosis measurements did not relate to degenerative changes except for subjects over age 50 with moderate or severe intervertebral narrowing. It is important to realize that although roentgenographic abnormalities represent structural changes in the spine, they do not necessarily cause symptoms.

ISSN:0362-2436    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

Posterior cervical fusion was performed in 34 patients with advanced rheumatoid atlanto-axial subluxation. Atraumatic surgical technique was used with local anesthesia and without skull traction. Intractable occipital rhizopathy and long-tract signs were the main indications. Anterior atlanto- axial subluxation in 28 patients was operated on with posterior fusion of C1-C2. Superior migration of the odontoid process into the foramen magnum in six patients was treated with posterior fusion of occiput C1-C2. Immediate mobilization in a plastic brace followed surgery. Average follow-up was 3 years. All patients became symptom-free, except for three who had remaining long-tract signs. Bony fusion was achieved in 17 patients; stable fibrous fusion, in 8 patients; and pseudoarthrosis, in 4 patients. There were no major postoperative complications. Five deaths occurred after 1-2 years from unrelated causes.

ISSN:0362-2436    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

Extensive simultaneous multisegment laminectomy (ESML) for treatment of ossification of the posterior longitudinal ligament (OPLL) in the cervical region is a technique which cuts the laminae on the median line and on the pedicles with an air drill, and then, the right and left halves of laminae are lifted simultaneously. This technique provides a protection to the spinal cord that swells instantaneously after decompression. A total of 155 cases were followed up for more than 1 year. According to the Japanese Orthopedic Association's evaluation criteria, 127 cases (81.9%) showed some improvement; specifically, 57 cases (36.8%) were rated excellent; 28 (18.1%), good; 42 (27.1%), fair; 11 (7.1%), unchanged; and 17 (11.0%) had poor results.

ISSN:0362-2436    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

System theory is used to describe the mechanism of the lumbar spine. The role of the spine in vertebrate evolution is presented. The importance of the intervertebral joint for the survival of the species is shown to be crucial. The mechanical behavior of the joint is derived, and from this the corresponding spinal motion and muscular responses is calculated. It is shown that physiologic behavior implies that the stress at the intervertebral joints is equalized and minimized. From this simple condition, the motion of the spine in the sagittal plane is calculated. From the analysis of sagittal plane motion together with a knowledge of the energy transfer through the intervertebral joint, a new theory of locomotion is derived. This theory of locomotion differs in important respects from current theories, but nevertheless explains available experimental data. This unified theory of the function of the human spine permits the determination of the level of safe loads that can be lifted and transported. It predicts the conditions of load transfer through a joint. It proposes a new approach to the mechanism of arthritis and to the repair of fractures.

ISSN:0362-2436    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

Midsagittal diameter (MSD) and interpedicular distance (IPD) in the thoracolumbar junctional region (T10-L1) of 24 male cadaveric spines were measured both from radiographs and directly from bones after removal of the soft tissues in order to assess the accuracy of plain radiographs. In addition surface areas of the vertebral canals were measured also from bone samples. It was found that the mean difference between bone and radiographic measurements in the IPD on different vertebral levels was 1.0 mm (r = 0.98). The MSD was a more difficult measurement, but the correlation coefficient was still 0.70, the mean difference being 0.7 mm or less. The sum of the MSD and IPD showed good relationship with the cross sectional area of the spinal canal, and the correlation coefficient was 0.77 (P< 0.001).

ISSN:0362-2436    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

Many different designs of upper distraction hooks for use in Harrington instrumentation are available. There is no published evidence to date to support the use of one hook in preference to another. This study compares the distraction force required to dislodge the three most commonly used designs of Harrington upper distraction hook. In cadavers the force required for failure of the plain, ribbed, and bifid hooks was compared as were the modes of vertebral fracture at the time of cut out. The bifid hook required a significantly greater distraction force to fracture the lamina, and the pattern of fracture was more extensive than it was with the plain or ribbed hooks.

ISSN:0362-2436    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

Five cases of hydatid disease affecting the vertebrae are described. Clinical features, radiologic appearance, and poor prognosis are emphasized. Four patients had some degree of neurologic deficit at the time of presentation and in three cases there was an increasing kyphosis. In two patients, spinal instrumentation with Harrington apparatus supplemented removal of hydatid material, and its use improved the previous neurologic deficit with stabilization of kyphosis. The antihelmintic drug mebendazole was used in two cases.

ISSN:0362-2436    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

Segmental spinal instability is a known cause of back pain, but no method of accurately quantifying instability exists. The movement of complex joints with rotational and translational components (such as the lumbar motion segment) is tracked by a pathway of instantaneous centers of rotation, or a centrode. Instability, ie, excessive and/or erratic movement, is reflected by increased centrode length in cadaver studies. This study describes anin vivomethod that precisely determines the centrode pattern and reports the results for 21 normal male volunteers who were studied at the L4-5 and L5-S1 levels. Each volunteer underwent lateral radiographs of the lumbar spine. High speed films were used and six positions, from full extension to full flexion, were recorded. Acetate tracings and contour matching techniques recorded the relative positions of the vertebral bodies on each film. Multiple tracings of each radiograph, combined with a digitizer and computer, were used to improve precision in the calculated centrode patterns. Centrode lengths measured 43.7 mm and 55.9 mm, respectively, for the L4-5 and L5-S1 levels. This study demonstrates that precise centrode pattern analysis for sagittal plane motion of the lumbar spine is possiblein vivo. Studies are under way to determine whether this technique will be useful as a clinical test in diagnosing early segmental instability of the lumbar spine in patients with low-back pain.

ISSN:0362-2436    

出版商:OVID    

年代:1986

数据来源: OVID