摘要:

Anteflexion and retroflexion movements of the cervical spine were recorded cineradiographically during three measuring sessions to determine reproducibility as well as intraindividual and interindividual variability of segmental instantaneous centers of rotation [recorded as “averaged” and “standard”). Segmental averaged instantaneous centers of rotation were based on data obtained from all frames of the cineradiographic film by the use of the average pentagon and moving average method. Only the first and last frame were used to construct the segmental standard instantaneous centers of rotation. Contrary to segmental range of motion, a parameter of quanityt of motion, the position of the averaged Instantaneous centers of rotation (better than the standard), a parameter of quality of movements, shows a variability of such low extent that it seems feasible to use it to diagnose abnormal mobility or in assessing therapy in the neck region.

ISSN:0362-2436    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

A retrospective study of 50 dens fractures was performed. In 47 of 50 cases (94%), plain radiographs disclosed the fracture. Initial cross-table lateral view alone showed the fracture in 43 cases. In the remaining four cases, routine plain films revealed the fracture: open-mouth view in three cases and lateral skull view in one case. In 3 of 50 cases (6%), plain films were negative, and fractures were seen only on tomography. Conventional circular tomography was performed in 28 cases; results were divided into 3 categories according to the significance of the findings: Category I, tomography confirmed plain radiographic findings, but added no further information; Category II, tomography detected additional findings or showed the extent of injury better than plain radiography; Category III, fracture was only seen by tomography. There were 19 cases in Category I, 4 in Category II, and 3 in Category III. Careful evaluation of plain radiographs remains the primary method for diagnosis of dens fractures. Tomography should be performed whenever plain radiographs or clinical symptoms are suspicious for dens fracture. In addition, tomography is useful to define the fracture level and pattern, which are improtant factors in the management of these injuries.

ISSN:0362-2436    

出版商:OVID    

年代:1992

数据来源: OVID

ISSN:0362-2436    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Since 1986 we have performed expansive laminoplasty with reattachment of the spinous processes and extensor musculature in cases of cervical myelopathy to avoid the late postoperative complications of extensive laminectomy. The operative procedure and results are given in detail. Forty cases (24 men, 16 women) were followed for a mean of 28 months. Postoperative results were satisfactory, with no major complications according to the evaluation criteria of the japanese Orthopaedic Association. No instability or malalignment was seen on postoperative radiographs.

ISSN:0362-2436    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

The effects of core temperature on three potentials - so matosensory spinal evoked potential, somatosensory cortical evoked potential, and spinal motor evoked potential were studied in rats. Hyperthermia reduced the latency and increased the conduction velocity of all three potentials. Somatosensory spinal evoked potential amplitude was unchanged, whereas somatosensory cortical and spinal motor evoked potentials deteriorated above 42 C. Hypothermia increased latency and decreased conduction velocity in all three potentials. The amplitude of the spinal motor evoked potential decreased, and the somatosensory cortical and spinal motor evoked potentials disappeared below 28 C. Hyperthermia and hypothermia caused significant changes in the latency of all three potentials. The latency change of all three potentials became significant at 2–2.5 C above or below baseline, suggesting a range within which evoked potential studies should be performed.

ISSN:0362-2436    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Spinal cord stimulation has been advocated as an alternative to motor cortex stimulation for motor tract activation. To test this theory, evoked responses were recorded from lumbar spinal cord (L2; n = 14), spinal roots (L4-L7; n = 112), peripheral nerves (sciatics; n = 28), and hind limb muscles (n = 28) after epidural stimulation of the T1-T2 segment of the spinal cord in dogs (n - 12), cats (n = 2), and monkeys (n = 2), The spinal response evoked by spinal cord stimulation was resistant to a dorsal hemisectioning (depth, 7–8 mm) of the midthoracic spinal cord. A minimal attenuation of atency and amplitude occurred with dorsal hemlsactioning, suggesting signal transmission through descending or ascending pathways in the ventrolateral and ventral quadrants of the spinal cord. The sciatic nerve response was abolished by a dorsal column transection (depth, 3–4 mm) or ipsilateral lumbar dorsal rhizotomy (four dorsal roots). This shows that the evoked response recorded from the sciatic nerve in our animals was not travelling, as we expected, through the ventral roots, but rather was conducted antidromically through sensory fibers in dorsal roots.

ISSN:0362-2436    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

A total of 258 patients with some degree of idiopathic scoliosis was monitored with both radiographs and moiré photography to determine the degree of progression of spinal curvature. The use of polaroid photography to document moiré fringe patterns proved to be a rapid and useful process for placing an instant photographic record in patiant charts while conducting routine physical examination. Standardization of procedures for making and evaluating moiré photographs reduced patient exposure to X-rays.

ISSN:0362-2436    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

The Perdriolle torsionmeter assesses vertebral rotation on a spinal radiograph. It is frequently used ot measure improvement in spinal derotation following Cotrel-Dubousset instrumentation for scoliosis. In this study, Intraobserver and intraobserver measurement error was examined during use of the torsionmeter. Intraobserver error was as follows: 53% of the measurements were accurate to within 5°. Error from the actual value averaged 6°. Interobserver error was as follows: Among six observers, only one third of the radiographs had measurements within 5° of each other. Another one third erred bymore than 10°. Because of this significant Intraobserver and Interobserver error, precise measurements of rotation using the torsionmeter cannot be expected. Efforts to quantify spinal derotaton with the torsionmeter after Cotrel-Dubousset instrumentation may not be valid.

ISSN:0362-2436    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

The purpose of this study was to document the diagnostic findings in a group of adult patients presenting with both scoliosis and pain. Fifty-five adults were evaluated by medical history, physical examination, radiography, myelography followed by computed tomography, discography followed by computed tomography, and single-and dual-photon densitometry. Curves were 49% adult degenerative onset, 44% idiophatic. The older degenerative patients had myleographic defects most commonly within the primary curve and multiple abnormal, not necessarily painful, discs throughout the lumbar spine on discography. The idiopathic group had myelographic defects most commonly in a compensatory lumbar or lumbosacral curve. On discography, all idiopathic patients had at least one abnormal, painful disc, and 88% had their pain reproduced. Pain-producing pathology was frequently identified in areas that would not have been included in the fusion area according to accepted rules for treatment of idiopathic scoliosis.

ISSN:0362-2436    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

This study consisted of 1,019 spinal fracture patients followed prospectively for 2 years. Sixty-foru physicians from 12 countries participated. The purpose of the study was to determine:1) the relationship between neurologic deficit and fracture type, level, and spinal canal compromise; 2) the neurologic outcome comparing surgical versus nonsurgicaltreatment and anterior versus posterior surgery; and 3) the relationship of pain to both kyphotic deformity and to surgical and nonsurgical treatment. The main findings of this study are as follows; 1) seat belts reduced the incidence of severe neurologic injury; 2) there was a higher incidence of neurologic deficit with fracture-dislocations and a higher incidence of neurologically intact patients with compression and flexion-distraction injuries; 3) there was a greater incidence of complete neurologic deficits caused by fractures at the spinal cord level, and a diminished incidence at the cauda equine level, and a diminished incidence at the cauda equine level; 4) for burst fractures there was a weakly positive relationship between canal compromise and neurologic deficit, including bladder function; 5) surgical intervention led to a greater percentage of improved neurologic function than nonoperative treatment, but the rate of improvement was not statistically different; 6) anterior surgery was not more effective than posterior surgery in improving the neurologic function when function was assessed using the Frankel or Motor Index scales, but it was statistically significant when compared to the Manabe scale; 7) in patients who deteriorated before surgery and underwent surgery, there was a greater improvement neurologically, particularly for anterior surgery, compared to those patients treated nonoperatively or to the overall surgically treated group; 8) There was a statistically significant relationship between bladder function and fracture type, with an increased incidence of absent function seen with fracture-dislocations, of impaired function with burstfractures, and of intact bladder function with compression and flexion-distraction injuries; 9) anterior surgery was more beneficial in improving complete bladder impairment to partial impairment compared to posterior surgery; 10) a kyphotic deformity of greater than 30° at 2-year follow-up was associated with an increased incidence of significant back pain; 11) patients who had surgery complained less of severe pain than those who were treated without surgery.

ISSN:0362-2436    

出版商:OVID    

年代:1992

数据来源: OVID