摘要:

Cervical spondylotic myelopathy was treated by a microsurgical anterior approach removing osteophytes completely. Follow-up results of 43 patients showed that 39 patients (91%) exhibited overall improvements of either 1, 2, or 3 grades on Nurick's grading. Four (9%) remained unchanged. Even severely affected myelopathic patients exhibited neurologic recovery. Cases that also had narrow cervical canals were treated by the same anterior osteophytectomy, and they showed similar responses. Six out of ten patients who had osteophytectomies without fusion developed neck and arm pain postoperatively, although the presence or absence of an interbody fusion did not affect the postoperative recovery from myelopathy.

ISSN:0362-2436    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

Proponents of the surface stimulation treatment of Idiopathic scoliosis have reported approximately 75–85% success rates in arresting progressive curvatures. Although encouraging, these results do not appear to be better than those of the more traditional brace programs. Now recognizing electrical stimulation as a viable alternative to bracing, supporters have advocated the psychologic and physical freedom with electrical stimulation as a major advantage over brace treatment. However, to date, there have been no objective psychologic studies to substantiate these claims. This prospective study was devised to detect any significant differences between a group of patients treated in a TLSO or Milwaukee brace and a group of patients treated with lateral electrical surface stimulation (LESS) (ScoliTron). The study consisted of 40 female private patients with idiopathic scoliosis treated for a minimum of 3 months. Each patient was given a set of seven standardized psychologic tests and an observer rating by the treating physician or physical therapist working with the patient. Results of the Psychological Epidemiology Research Interview (PERI) revealed that the LESS group had significantly higher self esteem than the brace group. The brace patients demonstrated a much greater perception of directed hostility than the LESS group. The coping response inventory showed the brace group to manifest a more primitive coping mechanism than the LESS group. The brace group attempted to avoid problems associated with their disease, rather than cope with them as the LESS group was better able to do. The brace group focused more on their emotions than the realistic problems of their disease. The Profile of Mood States revealed that the LESS group was much more physically active, vigorous, and outgoing compared with the more withdrawn and less active brace group. Results of the observer ratings showed the LESS group to be much less anxious, depressed, and more cooperative in their treatment program than the brace group. The brace group expressed a greater feeling of helplessness and discomfort with respect to their treatment program. The overall results of the study have shown that treatment in a LESS program has significant psychologic benefits over treatment in a brace program. The LESS patients were more active, outgoing, able to cope on a more advanced mature level, and had a lower level of personal and interpersonal disturbances.

ISSN:0362-2436    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

While an increased incidence of scoliosis in symptomatic spondylolysis and spondylolisthesis has been established previously, a comparison of its occurrence in symptomatic and asymptomatic individuals has not been performed. The present study is a comparison of symptomatic and asymptomatic young men with analysis as to the incidence of scoliosis. Idiopathic scoliosis was not found and all cases were due to spasm scoliosis or olisthetlic scoliosis with the spasm type being much more common. Scoliotic curves were divided into mild (0-9°) and moderate (10–20°). No case of a curve greater than 20° was seen. Scoliosis incidence in asymptomatic individuals without a pars break was 6.65%. In the groups of: (1) asymptomatic unilateral spondylolysis, (2) asymptomatic bilateral spondylolysis, (3) symptomatic bilateral spondylolysis, and (4) asymptomatic spondylolisthesis the scoliosis incidence was similar, ranging from 13.3–23.8%. These figures are significantly higher than those seen in the asymptomatic subjects without a pars break, but they are in the same range as in symptomatic patients without a pars break, suggesting that muscle spasm is the principal cause of the scoliosis.

ISSN:0362-2436    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

Twelve canine rib transposition grafts were harvested and evaluated for preservation of subperiosteal and medullary canal blood flow using the hydrogen washout technique. Blood flow using hydrogen washout technique also was studied in the T11 vertebral body. The mean hydrogen washout blood flow was 0.201 ml/min/ml tissue for the subperiosteal rib measurement, 0.058 ml/min/ml tissue for a rib medullary measurement, and 0.085 ml/min/ml tissue for the vertebral body. The medullary canal hydrogen washout values were consistently less than the subperiosteal values. The results have demonstrated that the blood supply to the vascularized rib pedicle can be retained and quantitated in harvesting the rib graft using the hydrogen washout technique.

ISSN:0362-2436    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

A retrospective study has been made of 264 posterior spinal fusions performed between 1972 and 1978 at the Good Samaritan Hospital in Cincinnati. Two hundred ten of the procedures were performed under hypotensive anesthesia. Blood loss and total blood replacement were related to the mean arterial pressure (MAP) during surgery. A 42% reduction in total intraoperative loss and a 28% reduction in total blood requirements were demonstrated. The results were significantly different when patient age was considered in adults maintained below 80 mmHg MAP, blood loss was decreased by 33%, but the total blood requirement was decreased by only 6%; in children under 18 years of age maintained below 90 mmHg MAP, the blood loss was decreased by 49% and the blood requirement by 42%.

ISSN:0362-2436    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

The literature describing menisci in the lumbar zygapophyseal joints is reviewed. The only true menisci in these joints are rudimentary fibrous invaginations of the dorsal and ventral capsule. So-called menisci at the superior and inferior poles of the joint are basically fatfilled synovial reflections, some of which contain dense fibrous tissue, which probably arises as a result of mechanical stress. The theory of meniscus entrapment is appraised, but is considered to have been an overstated cause of those forms of “acute locked back” that responds to manipulation.

ISSN:0362-2436    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

Out of 446 pupils aged 13–17 years, 115 were found to have a history of back pain. These pupils tended to have decreased lower limb joint mobility and increased trunk length compared with pupils without back pain. In 77 pupils whose site of back pain was identified, 38 had pain associated with the lumbar spine. These pupils had an increased trunk length while those with thoracolumbar or thoracic pain did not. Back pain was more common in those who avoided sports.

ISSN:0362-2436    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

To study spinal movements during work, an instrument that measured angles and angle changes in relation to a vertical plane was adapted to continuously measure forward flexion of the trunk. The instrument, which is battery-powered and worn on the back, registers the amount of flexion and its distribution over time during a work cycle by recording the time spent in each of five 18° intervals between 0° and 90°. Also the number of times that the angle of flexion changed from one interval to another is recorded. A total of 43 subjects from three occupations—dentistry, nurses' aide work, and warehouse work—were each tested during a 60 minute work cycle. On the average, the dentists spent most of the time (52.2 minutes) in a semi-flexed position not exceeding 36° and performed eight deep forward flexions (>73°). The nurses' aides spent one-half of the work cycle (34.4 minutes) in an upright position (0-18°) and performed 70 deep forward flexions. The warehouse workers spent less than one-half of the work cycle in an upright position (27.5 minutes) and performed 153 deep forward flexions that nearly always were associated with lifting.

ISSN:0362-2436    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

This paper describes the ranges of variation of characteristics present in human vertebral muscle. The samples used are from subjects who had a relatively brief history of spinal dysfunction. The samples have been taken in a precise manner and from a specific vertebral level with both sides of the vertebral column being studied including both superficial and deep muscles. These values for typical muscle for the ages investigated now can be used in studies involving abnormal vertebral muscle.

ISSN:0362-2436    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

Chymopapain recently has won approval in the United States for use in chemonucleolysis of herniated intervertebral discs. New research findings will be emerging, but clinicians need criteria by which to assess new results, to evaluate the existing literature, and to strengthen future investigation. Twenty-six original articles on chemonucleolysis were reviewed according to nine criteria of validity and applicability. Common threats to validity were failure to use randomized controls, make blind outcome assessments, assure equal co-treatments, and to calculate statistical power when results were negative. Threats to applicability included wide variations and incomplete reporting of patient selection, procedure technique, and many relevant outcomes. Methods for improving these design features are suggested, and a basic study design is proposed for comparing chemonucleolysis with both surgical and conservative management techniques.

ISSN:0362-2436    

出版商:OVID    

年代:1984

数据来源: OVID