摘要:

The Infantile nucleus pulposus is occupied by tissue derived from the notochord. The nucleus pulposus of this type is replaced by a different type of nucleus pulposus, composed of fibrocartllage and dense fibrous tissue at the first half of the second decade. In the adult, the nucleus pulposus shows morphologically high cell activities near the cartilaginous end-plate, including a process suggestive of regeneration. The surface layer of the cartilaginous end-plate and adjacent layer of the nucleus pulposus seems to play an Important role in the maintenance of the nucleus pulposus. Both the calcification within the cartilaginous end-plate, accompanied by bone formation, and Its superficial detachment, seems to destroy this layer and lead up to the obliteration of the disc.

ISSN:0362-2436    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

The purpose of this study was to determine whether or not computerized tomography myelography (CTM) gave an actual size and shape of the cervical spinal cord, and whether such dimensions reflected pathology of the spinal cord in cases suffering from compression myelopathy. Spinal cord transverse area and compression ratio (sagittal diameter divided by transverse diameter) were measured as indicators of spinal cord morphology. As a basis for this study, we first performed CTM of cadaveric cervical columns and compared the actual dimensions of the spinal cord of the cadaveric specimens with the CTM image. Second, the correlations between these dimensions and pathology of the affected spinal cord were investigated. The results showed that CTM provided a precise Image of the actual cross-section of the spinal cord. In 12 cadaveric specimens of cervical myelopathy examined, the transverse area and compression ratio were In good correlation with the severity of observed pathological changes.

ISSN:0362-2436    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

The ESCPs (evoked spinal cord potentials) resulting from both median nerve and spinal cord stimulation were recorded from the Interlamlnar yellow ligaments posteriorly or intervertebral discs anteriorly on patients with cervical myelopathy In order to determine the most significant lesion In the spinal cord electrophyslologically. The normal medlan-nerve-evoked spinal cord potential (MN-ESCP) consisted of P1N1 and N2(P2) deflections, while normal spinal cord-ascending evoked spinal cord potential (SC-AESCP) consisted of N1 and N2 deflections. The abnormal ESCPs obtained from 65 patients were classified Into three grades. The spinal level recording the highest grade of ESCP, which was mostly positive wave, generally corresponded to the level that was clearly diagnosed as the main lesion by neurologic and radlologlc examinations, such as a case of single level disc hernia. With these techniques, the level diagnostic rates of primary lesions were 94.7% in posterior recordings and 74.1% In anterior recordings.

ISSN:0362-2436    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

The purpose of this study is to establish the correct diagnosis of the location and extent of Intrasplnal cord lesions in cases of continuous or mixed-type ossification of the posterior longitudinal ligament and to estimate the postoperative prognosis using evoked spinal cord potentials (ESCP). Twenty-six patients, who underwent surgery from 1985 to 1987 and who have been followed for more than 6 months, were examined using a conductive ESCP, which demonstrates lower extremity, bowel, and bladder function, and a segmental ESCP and dermatome segmental ESCP, which demonstrate upper extremity function. A five-pole recording electrode was placed In the cervical epldural space. The stimulation sites were the thoracic epldural space for conductive ESCP, the median nerve at the elbow for the segmental ESCP, and the finger surface for the dermatome segmental ESCP. In cases In which the ESCP disappeared at the middle of the narrow cervical spinal canal, another stimulating electrode was placed In the cistema magna, and a descending conductive ESCP was recorded to monitor the upper border of the spinal lesion. New findings, which could not be observed by roentgenograms, myelography, and CT scan, were detectable using this technique.

ISSN:0362-2436    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

Thirteen rheumatoid patients who suffered from severe neck-occlpltal pain with or without myelopathy due to cranio-cervical instability, were operated on using a modified U-shaped rod. Twelve of them concomitantly had lower cervical rheumatoid lesions. Average extent of fusion was 5.9 levels. Bone union was confirmed In twelve cases in which autogenous bone graft had been used at approximately 4 months postoperatively; methylmethacrylate was used in the remaining one case. Good alignment of the cervical spine also was obtained in 12 cases; one patient experienced occipito-C2 shortening after an additional surgery for deep infection. Improvement of neck-occipital pain was noted In all cases, and seven of eight patients with myelopathy showed neurologic recovery.

ISSN:0362-2436    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

A free vascularized fibular graft with mlcrovascular anastomoses was applied to six clinical cases of anterior cervical fusion for carvlcal spondylosis with myelopathy (two patients) and ossification of the posterior longitudinal ligament with myelopathy in four. The numbers of levels fused were three In five patients, and two In one. Their follow-up period ranged from 14 to 42 months (mean, 26 months). Union of the graft occurred between 2.5 and 5 months (mean, 3.4 months) postoperatively. There were no nonunions nor any serious complications. This technique is indicated for multilevel Intervertebral fusion In which the nonunion or delayed union rate with conventional bone grafting may be high.

ISSN:0362-2436    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

Posterior decompression plus posterior reconstruction (laminoplasty) is a useful surgical method for treatment of cervical compresslve myelopathy. There are many laminoplasty procedures. This paper describes the Z-shaped laminoplasty developed by Hattori in 1971, and presents a clinical follow-up of the authors' experience with 130 patients. The procedure involves grinding the laminae down with an air drill and making a Z-shaped cut into the thinned laminae without excising the laminae. This technique enlarges the spinal canal. The purpose of this technique is to decompress the spinal cord and at the same time maintain clinical stability. Postoperative results were satisfactory without any major complication. Follow-up study was conducted in 78 cases with a minimal follow-up period of more than 2 years. Satisfactory clinical results were maintained for long periods postoperatively, and the enlargement of the spinal canal was well maintained as demonstrated on follow up X-ray study.

ISSN:0362-2436    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

The screening program for scoliosis started by Chiba University In 1979 consists of using moire topography, low-dose roentgenography and a final ordinary x-ray examination. The number of children screened through this Chiba University Medical School (CUMS) screening program to 1986 amounted to 1,246,798. The Incidence of scoliosis of more than 15° Increased linearly accord- Ing to age from the fifth grade primary school children (0.07% In boys, 0.44% in girls) to the second grade Junior high school students (0.25% In boys, 1.77% In girls). The female predominance of scoliosis cases with curvatures of more than 20° detected during the total period was 10:1 and this female predominance was the same for primary school children and junior high school students. According to a study of the incidence of scoliosis by districts, (areas were divided according to population density and urbanization) there were no significant differences In the fifth grade primary school children between the sparsely and densely populated areas. In the cases of children beyond the fifth grade primary school level, however, the incidence in the densely populated areas were significantly higher than those In the sparsely populated districts. The Incidence of scoliosis of more than 20° decreased significantly every year among junior high school students, because they were screened periodically In school and the scollotlc students who had already been detected were left out of the next screening. This study establishes that screening for scoliosis by the CUMS screening program is cost-effective with a low risk of radiation hazards.

ISSN:0362-2436    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

A retrospective study was conducted in 122 patients with idiopathic scoliosis who were followed for more than 2 years. There were 58 patients who showed 5° (Cobb) or more progression, and 41 patients who showed no progression. Only those who did not receive any treatment or who failed to comply with brace treatment were selected, to eliminate the effect of treatment. In the early phase of the study, 12 parameters were put into a multivariate analysis to observe the relative weight of each of them, which led the authors to eliminate the following five parameters: 1) Cobb angle, 2) rotation of the apical vertebra, 3) deviation of the apical vertebra, 4) Risser's expected correction: (standing angle - supine angle) X 3, and 5) maturation index of the Iliac apophysis. Through a multiple regression analysis, an equation was obtained to correlate the predictive and the real progression within 10° deviation.

ISSN:0362-2436    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

The authors' surgical procedure for the treatment of symptomatic thoracic disc herniation has consisted of total discectomy of the Involved intervertebral disc, followed by intervertebral body fusion using autogenous Iliac bone through an anterior approach. The authors prefer the extrapleural appraoch to the thoracic vertebrae because of simplified postoperative care with minimum surgical Interference with respiratory function. During the past 16 years, 23 patients with symptomatic thoracic disc herniation have been treated by this procedure. Preoperatively all 23 patients presented with some measure of paraplegia, with difficulty in walking. Their clinical presentation was analyzed and diagnostic aids to the thoracic disc herniation by radlographlc examinations were assessed. The radlographlc abnormality of ossification of the yellow ligament (OYL) coinciding with the Involved thoracic disc level was noted. The results in all 23 patients with this procedure were favorable. Based on the results of this series, this procedure is recommended for the treatment of symptomatic thoracic disc herniation.

ISSN:0362-2436    

出版商:OVID    

年代:1988

数据来源: OVID