摘要:

A review of 277 patients under the age of 16 years admitted to the pediatric spinal Injury unit at Rancho Los Amigos Medical Center from 1960 to 1989 showed that 70% of the patients were male; complete and incomplete Injuries were about equal; and the average age was 8.8 years. The cause of spinal injury by time period revealed that earlier time periods had etiologies similar to those reported in previously published series. Although the incidence of these traditional causes remained constant, violent injuries by gunshot steadily increased with time. In the most recent 5-year period, gunshot wounds equaled motor vehicle injuries as the most frequent cause of a child's spinal injury admitted to this hospital. Gunshot wound victims averaged 12 years old, 80% were male, and most were thoracic level paraplegics. Half of the 50 adolescents (12-16 years old) injured during the last 5 years were gunshot victims.

ISSN:0362-2436    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Thirty patients of a group of 39 patients with Scheuermann's kyphosis who underwent posterior spine fusion using large-diameter Harrington compression instrumentation were reviewed with a mean follow-up of 71.8 months. The mean curve Before surgery was 71.5 and at follow-up, 37.7 The mean loss of correction at review was 6. This is procedure was effective in adults with a fixed deformity as long as no anterior bony bridging existed. The authors believe that posterior Harrington instrumentation and spine fusion offer excellent correction of deformity at long-term follow-up without the added morbidity of a second procedure.

ISSN:0362-2436    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

The biomechanics of indirect reduction of bone fragments retropulsed into the spinal canal in a burst fracture were investigated. In this model, tunnels were created in vertesbrae L1 and C5 oriented anterior-to-posterior, allowing access to the posterior longitudinal ligament. A probe containing a load-sensing tip was passed through the tunnel. Both the location of the tip and the load acting on it by posterior deflection of tho posterior longitudinal ligament were measured. In the lumbar spine, distraction was applied by spinal instrumentation that also permitted Independent kyphotic-lordotic alignment of the vertebrae, In the cervical spine, axial traction was applied through direct loading. Several clinically relevant observations were made. It was not possible to produce an anteriorly directed force in the posterior longitudinal ligament at less then 35% canal occlusion, partly because the posterior longitudinal ligament stands away form the midbody of the vertebra. Distractive forces of up to 150 N were applied in the limbar spine, which were nearly equal to the tensile breaking strength of the relative sagittal plane angulation of the vertebrae, distraction was the governing factor in generating force in the posterior longitudinal ligament. Because positioning the vertebrae in lordosis before applying distraction significantly slackens the posterior longitudinal ligament, it is suggested that distraction be applied before angular positioning of the vertebrae is performed.

ISSN:0362-2436    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Scoliosis with progressive deformity can develop late in life. The authors studied 200 patients older than ago 50 years with back pain and recent onset of secolicsis Seventy-one percent of patients were women, and no patient had undergone spinal surgery. The curves involved the area form T12 to L5 with the apex at L2 or L3 and did not exceed 60°. Degenerative facet joint and disc disease always were present, and the curves were associated with a loss of lumbar lordosis. Forty-five patients with severe pain and neurologic deficits were studied using muyelography. Indention of the column of contrast medium was seen at several but was most severe at the apex of the curve. It was least severe at the Lumbosacral joint. the Curves progressed an average of 3° per year over a 5-year period in 73% of patients. Grade 3 apical rotation. a Cobb angle of 30 or more, lateral vertebral translation of 6 mm or more, and the prominence of L5 in relation to the intercrest line were important factors in predicting curve progression.

ISSN:0362-2436    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Gluteal activation and pelvic stability often are decreased in chronic low-back pain sufferers, but the importance of motor control and programming in treatment has not been fully evaluated. This study investigated whether gluteal muscles could be activated more affectively by stimulating the proprioceptive mechanism during walking. Labile support, through wearing “balance shoes,” offered facilitation of cerabellovestibular circuits, Electromyographic recordings of gluteus maximus and medius in 15 healthy subjects were made during barefoot and balance shoes walking before and after 1 week of facilitation. Singnificant increases (P<0.0002) in gluteal activity and significant decreases(P<0.01) In time to 75% maximum contraction, demonstrated the value of sensorimotor elicitation of subconscious and automatic responses in muscles often weakened in back pain sufferers.

ISSN:0362-2436    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Accurate noninvasive measurements of spinal curvature are crucial in planning treatment and assessing curve progression in adolescent idiopathic scoliosis. An inter-rater agreement trial and an intra-rater agreement trial were undertaken to estimate the reliability of axial rotation measurement using the Scoliometer (Orthopedic Systems, Inc., Heywood, California). In the Inter-rater trial, two orthopedic surgeon measured the thoracic and lumbar axial rotations of 22 patients with idiopathic scoliosis using the Scoliometer. In the intrarater, trial a single orthopedic surgeon measured the thoracic and lumbar axial rotations of 25 patients on four separate occasions with the Scoliometer. Inter-rater agreement using Scoliometer to estimate the magnitude of the hump (in centimeters) in the thoracic and lumbar regions was poor (intraclass correlation coefficient Rho = 0.57 a nd Rho = 0.76 for thoracic and lumbar regions, respectively). Inter-rater agreement using the Scoliometer to estimate the degree of axial trunk rotation was better (Rho =0.81 and Rho = 0.82 for the thoracic and lumbar regions, respectively). Intra-rater agreement using this device to estimate the magnitude of the hump (in centimeters) in the thoracic and lumbar regions was good (Rho = 0.90 and Rho = 0.84 for the thoracic and lumbar regions, respectively). Intrarater agreement using the Scoliometer to estimate the degreas of curvature was outstanding (Rho = 0.995 and Rho = 0.998 for the thoracic and lumbar regions, respectively). These results indicate that the Scoliometer can be a reliable noninvasive method for respectively assessing spinal axial rotation when used by a single trained observer.

ISSN:0362-2436    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

The long-term effect of Harrington instrumentation was investigated using posteroanterior radiographs and computed tomographic measurements preoperatively, postoperatively, and at a mean follow-up at 10.8 years in 33 patients with idiopathic scoliosis. No patient was lost form long-term follow-up. At follow-up, the mean Cobb angle was improved by 23.7 (40%) compared with the preoperative findings. The rotation of the apical vertebra was increased significantly. The rib hump, the translation of the apical vertebra, and the sagittal diameter of the thoracic cage were unchanged. At follow-up, the mean thoracic kyphosis was 17.3 and lumbar lordosis was 22.0 This study demonstrated that the long-term effect of Harrington instrumentation was limited to an improved Cobb angle; no correction of the rotational or sagittal deformities were achieved.

ISSN:0362-2436    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

This study was done to define and characterize those adult patients with scoliosis who will have problems of pain and/or progression leading to a surgical procedure and to review the results of these surgical procedures. The authors reviewed the cases of 49 adult patients who had undergone surgical treatment for scoliosis (average follow-up, 34 months; range, 24-140 months). The patients were categorized according to age, which allowed analysis of the data comparing age and the incidence and level of pain, age versus the degree of curvature, and age versus the incidence of progression. The relative incidence of pain and progression as indications for surgery were found to vary with respect to age. In the younger groups, progression was more often the indication for surgery than in the older groups. The Younger groups also had larger curves than did the older groups, on average. The degree of pain was not found to correlate with the magnitude of the deformity. Surgical Complications occurred in 20 patients; however, 14 of these were minor complications during the perioperative period, which did result in any sequelae. Surgical treatment can be done with a relatively low serious complication rate and good results in terms of pain relief and reasonable correction of the deformity.

ISSN:0362-2436    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Neurologic outcomes correlated with cervical canal diameter for 33 patients who sustained unilateral or bilateral facet fracutres, dislocations, subluxations, or perch injuries during a 9-year period. Lateral roentgenograms (target distance, 72 in.) were used to measure the canal and calculate the canal-body ratio (Torg's ratio) at the level of the vertebral injury. Frankel's classification system was employed to compare initial and final neurologic function. The most important factors that determined the long-term functional results after unilateral or bilateral injuries in the cervical spine were the degree of vertebral trauma and the serverity of the initial neurologic injury or the prognosis. Also, neurologic injuries were more severe in patients with bilateral facet injuries. No patients with complete injuries had an improvement in their Frankel grade.

ISSN:0362-2436    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

A retrospective analysis was done on 100 patients who had received cervical epidural steroid injections for neck pain and cervical radiculopathy to identify the predictors of outcome after such treatment. Potential predictors of outcome were assessed individually and then simultaneously with a multiple-regression model. Patients with radicular symptoms and signs had the best pain relief in contradistinction to those with axial (neck) pain. A clinical classification model predicting the outcome and an algorithm for the use of such injections in the treatment of cervical radiculopathy were developed.

ISSN:0362-2436    

出版商:OVID    

年代:1993

数据来源: OVID