ISSN:0362-2436    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

The data obtained from the history and examination of patients with low-back pain and sciatica have been subjected to an observer variation analysis. Redesign of the proformata resulted in a reduction of the observer error from 33% to 18% for the history, but no improvement in the finding of a 30% observer error in the examination. The clinician has a simple choice: if he wishes to obtain a large amount of detailed information he must realize that much of it will be unreliable; if he is prepared to limit the information then he will increase its reliability.

ISSN:0362-2436    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

Five common syndromes productive of low-back and leg pain are presented as the basis for clinical investigation to arrive at an early and definite diagnosis in low-back pain problems. The five are posterior facet syndromes, sacroiliac-piriformis syndrome, herniated nucleus pulposus, central spinal stenosis, and nerve entrapment in the lateral recess. All may present with a common symptom complex of low-back, buttock, trochanteric, and posterior thigh pain. Specific details from history, physical, and radiographic examination may allow separation of these entities, but proof of diagnosis requires data from response to treatment, facet and nerve injection, myelography, discography, and computerized tomography (CT) scan.

ISSN:0362-2436    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

Lumbar discography has been performed in over 1500 patients at St. Luke's Episcopal Hospital, and a report concerning 683 cases has been previously published. The authors review an additional 199 cases, finding that decision making was influenced by discography in 155 cases (78%). A positive discogram was surgically confirmed in 111 patients (56%). In 14(7%) the disc was found to be normal at surgery. One hundred six patients (53%) had positive discograms with negative or equivocal myelogram. In 36 patients with a positive myelogram, the discogram was corroborative, although most patients with positive myelograms did not have discography. Sixty-nine patients (35%) did not have surgery.

ISSN:0362-2436    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

It has been our practice to perform total myelography in all cases of lumbar disc disease including the various syndromes of spinal stenosis, because experience has indicated that myelographic abnormalities in the cervical and thoracic areas could have clinical importance despite the presence of gross changes in the lumbar region. Failure to establish a definite diagnosis by restricted lumbar myelography makes it mandatory to evaluate all levels of the spinal axis. Recently, 3 patients with thoracic spinal cord tumors presented with primary signs and symptoms of lumbar spine disorders. Evidence of spinal cord disease was minimal and could be readily overlooked. Total myelography disclosed varying degrees of lumbar spinal pathology, but also showed evidence of lesions in the thoracic region. One proved to be an intramedullary astrocytoma of the spinal cord, and two were schwannomas. The symptoms of low-back pain and lumbar radiculopathy improved after excision of the schwannomas and following x-ray therapy and chemotherapy in the patient with the intramedullary neoplasm.

ISSN:0362-2436    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

A reproducible method is presented for selecting patients with low-back pain and sciatica for lumbar discectomy based on specific objective criteria in four categories: neurologic signs, sciatic tension signs, personality factors (MMPI scores), and lumbar myelography. Operative findings for 50 consecutive cases selected using this method revealed complete nucleus pulposus herniation in 43 cases. This contrasts with complete herniation in only 5 of 26 patients undergoing lumbar discectomy before the method was employed. This objective preoperative evaluation method reduced negative disc explorations and improved early surgical results. We recommend its use for patients being considered for elective lumbar discectomy.

ISSN:0362-2436    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

Frequently, the diagnosis of disease of the low back is a difficult matter due to the multitude of factors affecting the patient's symptoms. In this report an attempt is made to use biomechanical testing to objectify certain aspects of the diagnostic process. Our philosophy is that a biomechanical assessment is one of the disciplines that should be brought to bear on the low-back pain patient. A group of biomechanical tests has been developed by adding quantitative measurement techniques to certain standard clinical maneuvers: muscle testing, range of motion testing, and straight leg raising testing. Moire fringe topography is employed for studying posture. Results of application of these techniques to 117 patients and 10 controls indicate potential utility in the method for epidemiologic and clinical research.

ISSN:0362-2436    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

This report assessed the relationship between patient selection and the outcome of lumbar disc surgery. Patient selecting is assessed by means of a predictive scoring technique previously reported. Because of the dynamic and ever-changing status of the lumbar spine with the passage of time, patient selectivity seems to be less critical after 5 years. For the first 5 years, however, the outcome of lumbar disc surgery seems to be directly related to patient selectivity.

ISSN:0362-2436    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

A retrospective review of the treatment of chronic back and extremity pain is presented. Laminectomy is most effective for pain secondary to direct compression of the neural elements. Treatment of pseudoradicular pain requires identification of the source of pain input. Facet rhizotomy is specific for pain arising from the posterior primary rami. Pain input from the recurrent sinuvertebral nerve requires epidural injection.

ISSN:0362-2436    

出版商:OVID    

年代:1979

数据来源: OVID

ISSN:0362-2436    

出版商:OVID    

年代:1979

数据来源: OVID