摘要:

Lateral cervical spine films from 175 normal examinations of adults performed in the emergency room of North Carolina Baptist Hospital were analyzed to establish some norms and relationships in the upper cervical spine. The predens angle was found to be between 0°-13° (mean 5.57°) in neutral position and 0-18° (mean 9.27°) inflexion in most persons. Ninety-two percent of persons have angles greater than 3° in flexion. A V-shaped predens space is not indicative of injury to the cruciate ligament. Virtually every person has posterior slanting or tilting of the dens and the range of values is up to 35° (mean 17.43°). Ninety-eight percent of persons have an angle greater than 6°. A tilted dens does not indicate acute or remote trauma. No relationship was identified between the predens angle and the dens tilt angle. The posterior arch of the atlas can be found at any position between the occiput and spinous process of C2 in all positions of the head and neck. Hence, fanning or widening of the C1-C2 interspinous distance is not a reliable index of ligamentous injury in the upper cervical spine.

ISSN:0362-2436    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

Stability of three types of double scoliotic curves of 10 - 40 ° was analyzed using a biomechanical model: double primary (Type I), primary thoracic with compensatory lumbar (Type II), and primary lumbar with compensatory thoracic (Type III). The load-carrying capacity of each curve was analyzed as a function of magnitude of the curve, its location and flexibility. Curve magnitude was found to be the most influential parameter governing the stability of a scoliotic curve up to 30°. Results suggest that in evaluating curves of comparable magnitudes, Type I and II curves are more likely to progress and, therefore, should be braced at an earlier stage than Type III curves.

ISSN:0362-2436    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

The presence of osteophytes compressing the sympathetic structures in the thorax was found in 655 (65.5%) of 1,000 cadavers. In 60.4% of the affected cases, the compression was on the right side, and in 36.9% it was bilateral, although the right side was more severely affected. In 2%, the compression was on the left only. The highest frequency of compression was at the T8-10 level, the right greater splanchnic nerve being the structure most frequently involved. The sympathetic trunk itself (ganglia and cord) was affected only by osteophytes of vertebrae at the lowest thoracic levels; however, bony excrescences due to costovertebral joint arthritis were frequently found impinging on the sympathetic trunk and its rami communicantes at similar frequencies on both sides. The factors governing the characteristic compression of the sympathetic structures in the thorax are the typical development of the osteophytes and the special relations of the sympathetic structures to the vertebral column at the various levels. It is proposed that these observations are useful in understanding certain observed clinical conditions and act an anatomic baseline for research in the future.

ISSN:0362-2436    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

Sacral dermatomal-evoked responses (DEP) and posterior tibial nerve (PTN) somatosensory-evoked potentials (SSEP) were recorded 28 hours after gunshot injury to the 12th thoracic vertebra of a 17-year-old male. Repeatable responses were obtained from stimulation of the fourth sacral dermatome despite absence of repeatable PTN responses. This suggestion of “sacral sparing” was accompanied by clinical improvement of neural function during the hospital course and 10 months after discharge. This case suggests DEP can make valuable contributions in the diagnosis of sacral sparing in acute spinal cord injury. Considerations regarding the unusual ipsilateral scalp recording location for sacral DEP are discussed.

ISSN:0362-2436    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

A case of an anterior spinal artery syndrome complicating an anterior spinal fusion is reported. Besides documenting a relatively rare complication of anterior spinal surgery, the level of the lesion (T6) and the association of spinal shock are relatively unusual. Intraoperative somatosensoryevoked potentials (SEP) deteriorated only transiently and failed to reflect adequately the neurologic injury either intraoperatively or postoperatively. The shortcomings of SEP monitoring are discussed, and the recommendation is made to use the combination of SEPs with the wake-up test when possible.

ISSN:0362-2436    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

A case is reported of an isolated posterior column injury secondary to direct mechanical trauma complicating a posterior spinal fusion. This case documents a rare complication of posterior spinal surgery. Intraoperative somatosensory-evoked potential (SEP) monitoring documented the injury whereas two intraoperative wake-up tests did not. This case demonstrates the value of intraoperative spinal cord monitoring in general. It also demonstrates the value of combining means to assess both anterior and posterior cord separately, intraoperatively. It is recommended that the wake-up test be used in conjunction with SEPs intraoperatively.

ISSN:0362-2436    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

Since 1984, 30 patients with burst fractures of the lower thoracic and lumbar spine were treated with AO internal spinal skeletal fixation system. All patients in this series had a minimum follow-up of 12 months. This new instrumentation is a posterior intrapedicular system developed by Dick in 1982. It allows stable fixation that is limited only to adjacent spinal segments. The internal fixator permits reduction in all three planes. Independently, it is possible to add distraction or compression to the involved segments. It also is able to reduce effectively the “middle column” which is thought to be accomplished by “ligamentotaxis.” In this series there were 16 neurologically intact patients and 14 with partial or complete neurologic injury. There were two minor instrumentation loosenings early in the series. Most patients in this series had a near-anatomic reduction of all three columns in the involved segment. It was also possible to re-establish the normal lordosis of the lumbar spine. The device provided sufficient rigid fixation for rapid postoperative mobilization in a light external orthosis.

ISSN:0362-2436    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

The undecapeptide, substance P, is known to be synthesized in cell bodies of dorsal root ganglia. This neuropeptide is also known to modulate sensory, nociceptive transmission postsynaptically on dorsal horn interneurons. In the animal model used in the current study, experimental mechanical stimulation of dorsal root ganglia and nerve roots increased the amounts of substance P, as well as substance P immunoreactivity in cell bodies of the dorsal root ganglia and in the substantia gelatinosa of the spinal dorsal horn that the cell bodies innervated. These results were determined by using both immunohistochemistry and radioimmunoassay. This study suggests that substance P may modulate nociception when lumbar nerve roots are stimulated mechanically.

ISSN:0362-2436    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

An experimental model of disc herniation in tail discs of rats is described. Constant result on nucleus hernia and intervertebral narrowing were obtained by an easy manipulation on numerous rats. Intradiscal injection of aprotinin produced a widening of the disc height. Trypsin, collagenase, chymopapain, and hyaluronidase induced a narrowing of disc height; trypsin induced macroscopic necrosis of the soft surrounding tissues; and collagenase had a destructive effect on nucleus pulposus, annulus fibrosus, and even on end-plates. Chymopapain and hyaluronidase acted mainly on nucleus pulposus. Hyaluronidase could be of interest as a nucleolytic drug and needs further studies on optimal dosage and lack of side effects in the surrounding tissues before injecting it into human discs.

ISSN:0362-2436    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

A study was undertaken to examine relations among some objective and subjective measures of low-back-related disability in a group of 41 low-back pain patients and in seven pain-free control subjects. Subjective measures of disability were obtained by Oswestry patient questionnaires. Oswestry disability score related significantly (P <0.001) to presence or absence of relaxation in back muscles during flexion. Mean trunk strength ratios were inversely related to disability score (P <.05), and trunk mobility was meaningfully reduced (P <.01). Despite loss of motion, a large enough excursion was observed to predict presence of back muscle relaxation. These findings imply that myoelectric signal levels, trunk strength ratios, and ranges of trunk motion may be used as objective indicators of low-back pain disability.

ISSN:0362-2436    

出版商:OVID    

年代:1987

数据来源: OVID