摘要:

Study DesignMorphological analysis was performed of the facet joint of the normal and spondylolytic lumbosacral spine in children and adolescents.ObjectivesThis study was performed to estimate the influence of spondylolysis on growth of the neural arch of the lumbosacral spine.Summary of Background DataThe development of the facet joint and its relation to spondylolysis have not been documented in the literature.MethodsThe dimension and orientation of the facet joint at L5/S were measured on radiographs and computed tomography scans from 144 boys without pars defects and 104 boys with pars defects. The latter group was further investigated according to the stage of pars defects. Patients in both groups were between 9 and 18 years of age.ResultsGrowth of the facet joint in the sagittal and transverse directions and the increase of the transverse angle were remarkable up to approximately 13 years of age. Concavity of the facet joints also progressed in children of the same age. The growth of the facet joint in patients with spondylolysis was significantly retarded as the pars defects advanced from the progressive to the terminal stage. The joint surface was more coronal in orientation and flatter in shape compared with controls.ConclusionsThe present results suggest that pars defects occurring in children disturb or retard the growth of the facet joint and that the morphological characteristics of the joint surfaces in patients with spondylolysis are the consequence of these defects.

ISSN:0362-2436    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Study DesignThis study was designed to construct the projection of the lateral sacral mass on the posterior ilium using cadaveric pelves and to measure the dimensions of the projection.ObjectivesThe present study was undertaken to determine quantitatively the location of the lateral sacral mass on the outer table of the ilium.Summary of Background DataAnatomic studies relative to instrumentation of the posterior iliosacral region are few. No previous anatomic studies with regard to the projection of the lateral sacral mass have been reported.MethodsTwelve cadaveric pelves were used for this study. To determine the projection of the lateral sacral mass on the outer table of the posterior ilium, several Kirschner wires were drilled along the outer-most peripheral edge of the lateral sacral mass from the inner table of the ilium through the outer table. A triangle projection on the outer table of the posterior ilium was then constructed according to the placed Kirschner wires. The widths and height of the projection, and the distances from the axis of the projection to posterior superior iliac spine and posterior inferior iliac spine were measured bilaterally.ResultsThe average height of the projection of the lateral sacral mass was 61.4 mm. The average base width of the projection was 56.8 mm. The average distances from posterior superior iliac spine and posterior inferior iliac spine to the longitudinal axis of the projection of the lateral mass were 30 mm and 27.4 mm, respectively.ConclusionsThis study reported the average location of the lateral sacral mass on the outer table of the ilium. The superior area of the projection may be an ideal zone for transiliosacral screw placement.

ISSN:0362-2436    

出版商:OVID    

年代:1996

数据来源: OVID

ISSN:0362-2436    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Study DesignThe measurement properties and validity of a newly developed patient questionnaire for the assessment of patients with lumbar spinal stenosis was tested in an ongoing prospective multicenter observational study of patients undergoing decompressive surgery in three teaching hospitals.ObjectiveThe goal of the study was to develop a short, self-administered questionnaire on symptom severity, physical functional status, and patient satisfaction.Summary of Background DataThe measure is intended to complement existing generic measures of spinal-related disability and health status. The questionnaire includes three scales with seven questions on symptom severity, five on physical function, and six on satisfaction.MethodsThe internal consistency of the scales was assessed with Cronbach's coefficient alpha on crosssectional data from 193 patients before surgery. The test-retest reliability was assessed on data from a random sample of 23 patients using Spearman's rank correlation coefficient. The responsiveness was assessed on 130 patients with 6-month follow-up data using the standardized response mean.ResultsThe test-retest reliability of the scales ranged from 0.82 to 0.96, the internal consistency from 0.64 to 0.92, and the responsiveness from 0.96 to 1.07. The direction, statistical significance, and strength of hypothesized relationships with external criteria were as expected.ConclusionsThis short self-administered spinal stenosis measure is reproducible, internally consistent, valid, and highly responsive. It can be used to complement generic instruments in outcome assessment of patients with lumbar spinal stenosis.

ISSN:0362-2436    

出版商:OVID    

年代:1996

数据来源: OVID

ISSN:0362-2436    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Study DesignA survey of pain intensity and psychological symptoms in patients with chronic neck pain after whiplash injury.ObjectivesTo describe the pain and psychological profiles of patients with chronic whiplash.Summary of Background DataReports in the literature mention a constellation of symptoms associated with chronic whiplash injury but no systematic survey using objective patient report measures has been reported.MethodsOne hundred forty consecutive referred patients with chronic neck pain after a motor vehicle accident were studied using the SCL-90-R psychological profile and the McGill Pain Questionnaire.ResultsPsychological profiles and pain intensity ratings, similar to profiles obtained from patients suffering from rheumatoid arthritis and low back pain of organic origin, were obtained.ConclusionsThe SCL-90-R is a convenient instrument to administer to patients with whiplash. It yielded a characteristic profile of pain and appears to be more expedient than other psychometric tests for these patients.

ISSN:0362-2436    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Study DesignLocal elastic moduli of sliced intervertebral disc specimens were studied after establishing the relation between the elastic modulus and indentation behaviors by model tests using polyurethane specimens.ObjectivesThis study presents a method to quantify the distribution of compressive elastic moduli in the lumbar intervertebral disc and to clarify the effects of degeneration on the distribution.Summary of Background DataNo study has been performed to evaluate the distribution of axial compressive elastic moduli, which is supposed to relate previous biomechanical, biological, and biochemical findings regarding the intervertebral disc.MethodsLocal compressive elastic moduli of the intervertebral disc were estimated by indentation tests. To evaluate the distribution of elastic moduli, indentation tests were performed at nodal points of a 10 mm × 10 mm network on a specimen. Nine cadaveric lumbar discs (L3-L4 and L4-L5) with various degrees of degeneration were tested. The age of subjects ranged 39 to 90 years (mean, 58.4 years).ResultsThe distribution of elastic moduli in normal discs was symmetric about the midsagittal plane. The mean elastic modulus in the nucleus pulposus was 5.8 kPa and those of the anterior and posterior anulus fibrosus were 110.7 and 75.8 kPa, respectively. The elastic moduli in the lateral portions were the lowest in the normal anulus, and were close to the values of the nucleus. Compared to normal discs, degenerated discs showed irregular distributions of elastic moduli. The elastic moduli of the degenerated nucleus were higher than those in normal discs.ConclusionsThe distribution of elastic moduli is much different between discs with and without degeneration.

ISSN:0362-2436    

出版商:OVID    

年代:1996

数据来源: OVID

ISSN:0362-2436    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Study DesignA biomechanical study on cadaveric lumbar spines was performed measuring interfragmentary forces and contact areas between intercorporal bone blocks and vertebral endplates.ObjectivesTo show the correct application of internal fixators to achieve interfragmentary compression between bone blocks and adjacent endplates.Summary of Background DataSeveral researchers have previously tried to compress interbody bone blocks by internal fixator systems. Knowledge of the correct way to use the internal fixator systems for this purpose has been lacking.MethodsTen cadaveric lumbar spines were analyzed by instrumenting each motion unit with an intercorporal bone block and a dorsal transpedicular arbeitsgemeinschaft osteosynthesefragen internal fixator. Interfragmentary load and compression surface and their distribution were measured with a capacitive measuring mat. The internal fixator was loaded in compression in two different ways to determine the optimum mode of application.ResultsSimple compression of an internal fixator did not achieve sufficient interfragmentary forces and compression surfaces. Usually lordotic contouring of the instrumented spinal motion unit with a decrease in interfragmentary forces and width of compression surfaces developed. Preloading the fixator in slight kyphosis and compressing it in a second step achieved significantly improved interfragmentary forces and sufficient compression surfaces.ConclusionsPreloading an internal fixator in kyphosis and secondary compression is mandatory to get sufficient interfragmentary forces and compression surfaces between interbody bone blocks and adjacent vertebral endplates. The technique described provides a compressive interbody fusion and can be performed preserving the physiological shape of the spine.

ISSN:0362-2436    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Study DesignThis study was designed to reveal the progression pattern and essential histological findings of the lesions in the spinal cord affected by cervical spondylotic myelopathy.ObjectivesThe purpose of this study was to gain new information about symptom progression and recovery in cervical spondylotic myelopathy.Summary of Background DataThe characteristics of the distribution and the progression pattern of the lesions and whether demyelination and remyelination processes actually occur in cervical spondylotic myelopathy remain unclear.MethodsTissues from seven patients with cervical spondylotic myelopathy were taken during autopsy and examined macroscopically and microscopically. An ultrastructural examination of spinal cord from two patients was also performed.ResultsThe anterior horn and intermediate zone of the gray matter in the compressed segments showed atrophy in all the cases and in one, atrophy was limited to these areas. Atrophy and myelin pallor in the lateral and posterior funiculi were observed in six patients, and the lateral funiculi of two were severely affected. Many thin myelinated fibers and denuded axons were demonstrated ultrastructurally in the damaged white matter of two patients.ConclusionThere appears to be a common pattern of lesion progression in cervical spondylotic myelopathy: atrophy and neuronal loss in the anterior horn and intermediate zone develop first, followed by degeneration of the lateral and posterior funiculi. Eventually, marked atrophy develops throughout the entire gray matter and severe degeneration occurs in the lateral funiculus. Furthermore, the existence of thin myelinated fibers in the white matter suggests focal demyelinating and remyelinating processes occur in cervical spondylotic myelopathy.

ISSN:0362-2436    

出版商:OVID    

年代:1996

数据来源: OVID