摘要:

During routine autopsies in 11 cadavers, the intact dural sac, including its nerve roots, was circumferentially constricted by a clamp while the pressure under the clamp among the nerve roots was recorded simultaneously. The first sign of a pressure increase—the critical size—occurred at a cross-sectional area of the cauda equina of 77 ± 13 mm2. To achieve a pressure increase of 50 mm Hg, the cross-sectional area of the cauda equina had to be further constricted at an average of 19 ± 8%. The corresponding constriction needed to achieve a pressure of 100 mm Hg was 26 ± 8%. The results indicated that constriction of the cauda equina to a size less than 75 mm2probably will affect the normal function of the nerve roots of the cauda.

ISSN:0362-2436    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

Pain drawings were obtained from two groups of patients and one of nonpatients, in a total of 264 subjects, all suffering from back pain. The pain drawings were rated in four grades according to the degree of nonorganic and extended pain. The reliability was excellent with an intra-and interrater agreement of 80 and 70%, respectively. Three quarters of the nonpatient group had dull aching pain in the lower back only, whereas widespread or nonanatomlcal pain was prevalent in patients responding poorly to treatment. A correlation was also found to ethnic background and social situation but not to alcohol abuse or psychiatric illness. Pain drawings afford an important clue to nonorganic factors in the assessment of back pain.

ISSN:0362-2436    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

Limitation of straight-leg raising (SLR) (Lasègue's sign) is considered an important test in the diagnosis of herniated lumbar disc disease. In a prospective study of 55 patients suffering from unilateral sciatica this sign was evaluated. Two aspects were Investigated: 1) the interobserver variation, and 2) the correlation between the result of the test and the surgical finding. There was considerable Interobserver variation among three observers concerning the measured angle at which pain was elicited. However, in 2/3 to 3/4 of the cases the variation amounted to 10° or less. There was also sortie discordance in the classification of the type of pain that was elicited. Fifty-two patients underwent surgery; 45 had a prolapsed disc. SLR was “positive” in 49 cases, 43 of whom harbored a prolapsed disci Crossed SLR was noted in 20, 19 of whom had a prolapsed disc at surgery. Absence of SLR limitation does not preclude the presence of a herniated lumbar disc.

ISSN:0362-2436    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

During 127 operations for the correction of spinal deformities the spinal cord function was controlled by Intraoperative monitoring. Cortical somatosensory evoked potentials (CSEP) were obtained by bilateral stimulation of the posterior tibial nerves at the ankle and recorded from electrodes at Fz-Cz. In addition, unilateral median nerve stimulation at the wrist was carried out to act as a control. Six cases with significant Intraoperative alterations In wave-form and their postoperative neurologic status are described in detail. EP monitoring permits continuous monitoring of the patient for the total duration of operation and is therefore superior to the wake-up test. This method is particularly advisable for operations carried out in hypotensive anaesthesia as well as for postoperative control.

ISSN:0362-2436    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

The natural history of idiopathic scoliosis has been studied between 1969 and 1985 in a well-controlled population of school children; 66,200 cases, between 7 and 16 years of age. The incidence of scoliosis needing treatment (25° or more in progress in growing children) was studied with a cross-sectional as well as a longitudinal survey. When using a cross-sectional technique, a decrease of cases being treated was seen after the Introduction of a conventional screening program—thus indicating a change in the natural history of moderate scoliosis. This could, however, be explained by the consequence of an accumulation of treated cases, formerly diagnosed and treated later on, seen immediately after the Introduction of screening. When the longitudinal method was used, this trend could not be observed. And finally, when taking changes of indication of treatment and of the population into consideration, no tendency at all toward a change in the natural history could be seen.

ISSN:0362-2436    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

The value of surface topographical measurements In the assessment of curve progression in adolescent idiopathic scoliosis is demonstrated in a group of 51 patients. Cobb angles at the commencement of the study ranged from 10° -55° (mean 34.5°), and the mean follow-up period was greater than 2 years. The surface shape method correctly identified curve evolution in 84% of the patient group. Of these, the eight patients who underwent spinal instrumentation were correctly predicted as candidates for surgery.

ISSN:0362-2436    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

Photofluorography using a large-field image intensifier (Siemens Optilux 57) was applied to scoliosis radiography and compared with a full-size rare-earth screen/film technique. When scoliosis radiography (PA-projection) was performed on 25 adolescent patients, the photofluorographs were found to be of comparable diagnostic quality with full-size films. A close correspondence between the imaging techniques was found in the Cobb angle measurements as well as in the grading of rotation with the pedicle method. The use of photofluorography results in a radiation dose reduction of about one-half and considerable savings in direct imaging costs and archive space. In our opinion the method is particularly well-suited for follow-up and screening evaluation of scoliosis, but in tall patients the image field size of 40 X 40 cm restricts its usefulness as initial examination.

ISSN:0362-2436    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

The aim of this study is to see how the spinal sagittal configuration and mobility in 127 patients with idiopathic scoliosis are influenced by increasing scoliotic deformity and to determine when this deformity gets clinically significant compared to controls (n=92). In patients with thoracic curves the degrees of thoracic kyphosis and lumbar lordosis were significantly less than those of the controls. Neither the kyphosis nor the lordosis were correlated to the Cobb angles. Even patients with small curves have straight spines in the sagittal plane; there is no tendency for the kyphosis and lordosis to decrease when the scoliotic deformity increases. This indicates that it is especially individuals with straight spines in the sagittal plane who are prone to develop scoliosis. It is also suggested that the limitation in spinal function for curves with Cobb angles below 50° may be neglected.

ISSN:0362-2436    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

Ten myelomeningocele patients with a severe lumbar kyphosls were treated by resection of their kyphus, Internal fixation, and spinal fusion. A mean kyphosls of 131° was reduced to 44° following the surgery. This was a very major procedure, associated with many complications. One patient died during the surgery and the remaining nine patients were followed for a mean of 7 years 4 months to skeletal maturity. The most successful methods of Internal fixation were either by two Harrington distraction rods combined with compression across the osteotomy site (Group 3) or by a posteriorly applied AO plate (Group 2). A long posterior fusion extending from the mid-thoracic region to the sacrum was necessary to provide long-term stability and prevent the development of a thoracic lordosis. At skeletal maturity, all seven patients in Groups 2 and 3 had a flat back without pressure sores and all were able to sit upright without using their arms for support.

ISSN:0362-2436    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

Eighty-three patients with unstable cervical spine injuries were treated with halo-vest stabilization in a prospective consecutive series during a 10 year period. At the follow-up 2-7 years after the trauma, six patients had died and eight patients had been surgically stabilized. Sixty-seven of the remaining 69 patients (97%) were subjected to the follow-up performed with validated protocols. All patients but three were reexamined clinically and radiographically. Flexion-extension motion and sidebending of the neck was measured radiographically. Rotation was measured with the aid of a compass placed on top of the head of the patient. Fortyfour patients (53%) had initial neurological deficit, 26 with tetraparesls. The age range was 13-89 years and the male/female ratio was 2/1. The halo-vest treatment period was 10-12 weeks. The 1 year healing rate was 90%. Seven nonunions occurred, all in fracture types known to be prone to nonunion. Complications during the treatment were usually minor, with pin problems being the most frequent (pin loosening 60%). At the follow-up, approximately 80% of all patients had complaints of local neck symptoms. Pain at the extremes of neck motion and stiffness was the most frequent. The symptoms were mild and did not not usually have any major impact on return to work or leisure activities. Seventy-five percent of patients with incomplete cord lesions and useless muscle function improved to useful function. The patients had a statistically significant decrease of rotation (18%) and sidebending (18%) of the neck but normal flexion-extension motion when compared to the normal.

ISSN:0362-2436    

出版商:OVID    

年代:1988

数据来源: OVID