摘要:

Twelve specimens of the upper cervical spine were functionally examined by using radiography, cineradiography and computerized tomographic (CT) scan. The range of rotation was measured from CT images after maximal rotations to both sides. The left alar ligament was then cut and the examination repeated. The alar and transverse ligaments could be differentiated on CT images in axial, sagittal, and coronal views. Rotation at occiput-atlas was 4.35° to the right and 5.9 ° to the left and at atlas - axis it was 31.4° to the right and 33° to the left. After one-sided lesion of the alar ligament, there was an overall increase of 10.8 ° or 30% of original rotation to the opposite side, divided about equally between the occiput - atlas and the atlas - axis. It is concluded that a lesion (irreversible overstretching or rupture of alar ligaments) can result in rotatory hypermobility or instability of the upper cervical spine.

ISSN:0362-2436    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

A technique is described for posterior cervical stabilization with wire and fusion using iliac crest bone graft, performed under local anesthesia. Thirty-four consecutive cases performed at Rancho Los Amigos Medical Center are reviewed. In patients with unstable cervical spines and variable degrees of neurologic injury, posterior stabilization and fusion using local anesthesia allows the patient to interact with the surgeon during crucial moments of spinal manipulation. The technique is well tolerated by patients, and no untoward complications have occurred with use of this technique.

ISSN:0362-2436    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

Advances in radiologic technology have allowed the identification of a variety of cystic lesions of spinal nerve roots. Failure to appreciate the different characteristics of these cysts has led to a confusion in terminology, with different terms often being used to describe the same lesion. In an attempt at clarification, the literature is reviewed and a simplified classification of spinal cysts presented. The distinguishing features of each type of cyst, its investigation, and appropriate treatment are discussed.

ISSN:0362-2436    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

A modified spinal cord puncture technique that was combined with CT metrizamide syringography for the evaluation of potentially cystic spinal cord lesions has been used in 5 patients. This procedure proved to be safe and efficacious in the preoperative differentiation of cystic neoplasms from syringohydromyelia. It also aided in planning a surgical approach by revealing details of the tumor location and/or syrinx dynamics. Spinal cord puncture associated with CT metrizamide syringography has a role in the diagnosis and therapy of patients with cystic spinal cord lesions.

ISSN:0362-2436    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

One hundred fifty-two consecutive spinal fusions were performed over a 4-year period in 143 patients. Autogenous bone was used in 62 patients and frozen cryopreserved bone in 90. A variety of anterior and posterior procedures with and without instrumentation were performed. The percentage of successful arthrodesis was 87 in those who received autogenous bone, and 86.6 in those who received allograft bone. Thirty-four spinal fusions were surgically explored. Histologic evaluation of the bone taken at the time of surgical exploration showed viable osteocytes laying down osteoid, woven and lamellar bone, and no inflammatory or foreign body reaction. The authors conclude that cryopreserved bone, harvested and processed as described, is advantageous, safe, and results in a rate of bone union comparable to that of autogenous bone.

ISSN:0362-2436    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

A method of calculation of biplanar spinal deformity in which the frontal Cobb angle is added to the deviation from normal sagittal alignment is presented. Three equivalent groups of adolescent idiopathic scoliosis treated by different surgical methods are presented. When only the frontal Cobb method of comparison was used, results were similar. When the composite measurement that takes into account sagittal changes was used, the Harrington instrumentation group showed significantly poorer results than the Luque rod and Cotrel-Dubousset rod groups. The composite measurement, considering sagittal alignment, is a significantly more valid method of description of the scoliotic deformity and of comparison of treatment methods.

ISSN:0362-2436    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

Diplomyelia is an uncommon variant of diastematomyelia in which the spinal cord remains divided caudal to the diastematomyelia spur. Presented here are three adults who presented with a sign-and-symptom complex that is likely to occur only when such an anatomic aberration is found. Each patient complained of pain and paresis in one leg. Neurologic examination demonstrated dysfunction of not only both long tracts but also lower motor modalities in the symptomatic leg and no abnormalities in the opposite leg. These findings, therefore, would strongly suggest that each leg was supplied by one of the split spinal cords, with only one cord being compromised. When planning surgical intervention on these patients, one must be aware that removal of the central spur alone may not resolve the problem because the spur, unlike that in diastematomyelia, does not tether the split spinal cords.

ISSN:0362-2436    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

Between 1976 and 1984, twenty-one patients with ankylosing spondylitis were treated surgically. Eight patients with rigid thoracic kyphosis underwent a two-stage combined procedure. The average correction was 36°. Eight patients underwent a single-stage lumbar osteotomy with Harrington compression instrumentation. The average correction was 31 °. Five patients presented with stress fractures and back pain. All underwent combined anterior and posterior surgery. The average correction was 9°. Two patients underwent anterior decompression for progressive paraplegia. Both showed improvement in neurologic function. At follow-up, all but one patient had improvement in pain and spinal alignment. There have been no deaths or persistent neurologic problems from these procedures.

ISSN:0362-2436    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

The authors reviewed the results of the combined ventral derotation system (VDS) and Harrington operation in 34 selected patients with idiopathic scoliosis and kyphoscoliosis of double major curve pattern. The use of both VDS and Harrington instrumentation gives better correction and stabilization of the particular curves. It is thought that a greater degree of correction can be obtained in the lumbar curve, thus putting the spine into balance and correcting the kyphosis. The L4 could be centralized and made horizontal, in most operated cases, above the midsacrum. Another useful advantage of the combined procedure is “saving” lower lumbar functional segments.

ISSN:0362-2436    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

Increased lumbar lordosis places increased stress on the pars interarticularis. Fatigue fractures of the pars can result in spondylolysis. There was a 50% incidence of asymptomatic spondylolysis in 18 patients who had Scheuermann's kyphosis and an increased lumbar lordosis. This significant increase further confirms the patho-genesis of spondylolysis. Patients with Scheurmann's disease with low-back pain should be evaluated with oblique radiographs of the lumbar spine to rule out spondylolysis.

ISSN:0362-2436    

出版商:OVID    

年代:1987

数据来源: OVID