摘要:

This is a retrospective study of 67 patients, seen during a 4-year period, with cervical pathology requiring surgical correction. The purpose of this study was to evaluate the usefulness of a new physical finding (dynamic Hoffmann's sign) in diagnosing early cervical myelopathy or in suggesting a narrow cervical canal clinically. Hoffman's sign was checked with the head in neutral (static) and during multiple active full flexion to extension as tolerated by the patient (dynamic). Forty patients had negative Hoffman's signs, 20 had positive static Hoffman's signs, and 7 had positive dynamic Hoffman's signs. Canal measurements were made on eight randomly selected negative patients on both plain films and myelographic studies, and on the seven positive patients. A positive dynamic Hoffmann's sign was consistent with a narrow sagittal diameter of the cervical canal, and aided clinically in making the diagnosis of early cervical spondylotic myelopathy or congenital cervical narrowing.

ISSN:0362-2436    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

The incidence of adverse reactions following standard film or screen cervical myelography with iohexol in 32 adult outpatients was reported, lohexol at a dose of 1,080–3,000 mg of iodine was administered via a lateral C1-C2 approach in 26 patients and via a lumbar route in 6 patients. All 32 patients underwent postmyelographic cervical spine computed tomography and were discharged after the procedure was completed. No adverse reactions occurred in 53.1% of patients. The most common adverse reaction was headache (31.3%); other minor adverse reactions included exacerbation of pre-existing pain (12.5%), neck stiffness (9.4%), and vomiting (6.3%). Good to excellent technical quality was seen on all myelograms and computed tomographic scans. Outpatient cervical myelography with iohexol appears to be a safe and cost-effective alternative to inpatient examination.

ISSN:0362-2436    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

Seventy-nine somatosensory evoked potentials were intraoperatively recorded in 52 patients undergoing spinal surgery for nonidiopathic spinal deformities. There were 37 true-negative, 28 true-positive (a significant change in the somatosensory evoked potential related to the surgical process), and 14 false-positive (a significant change in the somatosensory evoked potential not related to a surgical event) readings. There were, however, no postoperative neurologic deficits with any of the true-positive readings and no false negatives. Spinal and subcortical somatosensory evoked potentials gave few false-positive readings. True-positive somatosensory evoked potentials occurred in 44% of the patients with neuromuscular deformities, 17% with congenital deformities, 45% with Luque instrumentation, 22% with Harrington instrumentation, and none with fusionin situ.Fifty percent of the true positives occurred while the sublaminar wires were tightened. The predictive accuracy of intraoperative spinal cord monitoring in this patient population is not high, but the sensitivity to potentially harmful surgical events is high.

ISSN:0362-2436    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

Spinal epidural lipomatosis associated with Cushing's syndrome is an uncommon complication (11 reported cases). Two additional symptomatic cases with neurologic deficit are described. Steroid treatment was systemic in the first case and local with epidural injections in the second. The second case is unique because no similar observations have yet been reported. In most cases, a preoperative computed tomographic scan establishes the diagnosis by demonstrating dural compression by an adipose mass. Myelography is far less specific. In some cases, the exact diagnosis is made at the time of surgery. The treatment is primarily surgical, with laminectomy over the length of the compression and the removal of the compressing fat. Neurologic recovery is dependent on two factors: the level of the compression and the adequacy of decompression.

ISSN:0362-2436    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

In order better to define the prevalence and characteristics of idiopathic vertebral sclerosis, we evaluated the roentgenograms of 1,391 individuals > 35 years of age) for the presence or absence of idiopathic vertebral sclerosis. One hundred two radiographs showed evidence of idiopathic vertebral sclerosis, a prevalence rate of 5% in this population. For the first time, a roentgenographic classification is offered. These “cases” were then classified into Types I-IV, based on the pattern and location of the sclerosis. The radiologic and demographic characteristics of Type I correlate most closely with previous studies that have investigated the association of vertebral sclerosis with chronic back pain. Women predominated in age-specific classifications; the female-to-male ratio in Type I was 4:1, a reproducible finding in previous studies. The large sample available for study supports the conclusion that this is an accurate estimate of the prevalence rate of idiopathic vertebral sclerosis.

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

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