摘要:

A histopathologic study of the spine from a child with congenital scoliosis indicates that the major problems relate to the vertebral bodies, which are irregular in size, shape, and position, and to the adjacent intervertebral discs, which are always abnormal. Bone and cartilage as tissues, however, are histologically and histochemically unremarkable; it is their positioning which is irregular. No molecular abnormality of collagen could be found in bone, cartilage, or skin. Pathogenesis is discussed in reference to theories of general and vertebral morphogenesis. The findings of abnormal spatial deposition of histologically and biochemically unremarkable tissue are consistent with inductive abnormalities of the notochord. The clinical and radiologic manifestations in congenital scoliosis are a combination of primary embryologic abnormalities, secondary developmental abnormalities which spring from them, and tertiary developmental irregularities.

ISSN:0362-2436    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

A review of 13 cases of symptomatic isolated congenital cervical fusion (block vertebrae) below the C2 level is presented. Ten cases were collected from a review of the English literature and three new cases were added. All 13 patients presented neurologic symptoms of radiculopathy and/or myelopathy with either no history of trauma or only minor trauma. Pathogenesis of symptoms is due to degenerative arthritis of the adjacent mobile segments, spinal stenosis, and subluxation of the adjacent mobile segments. The significance of coexisting spinal stenosis and segmental instability is emphasized and is related to the symptoms and treatment of the condition. Symptomatic patients can be treated satisfactorily with adequate decompressive laminectomy and fusion of the unstable segments.

ISSN:0362-2436    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

Combined anterior and posterior fusion provides and maintains good, correction in patients with Scheuermann's kyphosis. A fusion which includes the entire deformity, especially at the lower end, is a requisite for a satisfactory result. Intervening halofemoral traction may not improve results. Pulmonary functions may decrease somewhat postoperatively but, in the large majority of cases, still remain within normal limits. We think that anterior and posterior fusion remains the procedure of choice in severe or rigid Scheuermann's kyphosis.

ISSN:0362-2436    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

A clinical trial of an intraoperative autogenous blood recovery system shows that while the method is safe, the cost in spinal surgery is quite high. The unit was used in 20 procedures in 18 patients thought to have increased risk of intraoperative bleeding (mature idiopathic, congenital, myelomeningocele, Marfan's, and irradiation scolioses and late spinal fractures). Collection in four procedures was either insufficient for use or contaminated. In the remaining 16 cases, 20% of the blood loss was recovered. A total of ten units of blood was recovered, at a cost of $283/unit; this is four times the current cost for a unit of blood in the local blood bank. The method would be more beneficial if a huge blood loss were anticipated, as most of its cost is incurred in the setup, and the higher the blood loss at surgery, the higher the percentage of the yield might be. The method may be useful with rate blood types and for patients with religious objections to transfusions.

ISSN:0362-2436    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

Nineteen scoliotic patients were treated with the standard Harrington distraction rod supplemented with transverse traction. The latter consists of a compression device (either Harrington's or Cotrel's) applied to the convex side of the curve to correct disc space wedging and then drawn toward the distraction rod with a simple traction apparatus. Intraoperative roentgenograms were taken with the Harrington distraction rod alone after maximal distraction was applied. This was followed by postoperative roentgenograms with the transverse traction added. The 50.3% correction by distraction rod alone is increased to 66% with the addition of transverse traction. Detailed analysis of each curve, segment by segment, showed that the correction was augmented, not only in the center of the curve, where the compression corrected disc space wedging, but in the ends of the curve as well. This series uses each patient as his or her own control in demonstrating increased correction added by transverse traction.

ISSN:0362-2436    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

Three-dimensional observation of the collagen framework of lumbar intervertebral discs by scanning electron microscopy confirmed that the fibrillar framework of the annulus and the cartilage end-plate encircles the nucleus as a closed pack system. The cartilage end-plate was made of dense collagen framework aligned horizontally. There was no interconnection between the cartilage end-plate and the lamellar subchondral collagen. In places, the vascular channels ran directly at the end-plate. In the inner one third of the annulus, obliquely oriented fibrillar lamellae interconnected with the cartilage end-plate. In the outer two thirds, the fibrillar lamellae were formed from fibrillar bundles and were firmly anchored into the vertebral bodies. Architectural relationships between the disc and the vertebral bodies are discussed.

ISSN:0362-2436    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

The bone mineral content and the ultimate compressive strength were determined in 109 fresh lumbar vertebrae from 36 different subjects, 31 to 79 years of age. The degree of macroscopic disc degeneration and the types of fracture were determined. Three types of fracture—central, wedge and transverse—were found, but only under magnification and at simultaneous movements of the fracture segment. The central type of fracture was found predominantly in specimens with high bone mineral content surrounded by normal discs. The wedge type of fracture was consistent with lower bone mineral content and more severe disc degeneration.

ISSN:0362-2436    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

The influences of differences in both intervertebral motion segment orientations and in reader judgments on measurements of the apparent intervertebral disc heights in lateral roentgenographs of the lumbar spine were examined. Forty-nine roentgenographs were obtained of nine discs that were tilted laterally up to ± 10 degrees, and rotated longitudinally up to ± 20 degrees. Three orthopaedic surgeons and three radiologists measured disc heights from five of these roentgenographs, all using the same measurement method. The differences in apparent height that resulted from the orientation changes and differences in judgments among the six readers were considerable, usually of the order of one half of the nominal disc height. The results show that, while roentgenographic measurements can be used to estimate disc height, accurate measurements cannot readily be made from routine roentgenographs, and the interpretation should always be cautious.

ISSN:0362-2436    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

Intraosseus pressure in the lumbar spine is defined as the hydrostatic pressure of venous blood in the trabecular sinusoids of cancellous bone. Measurements of it in the lumbar vertebrae and the inferior vena cava confirm that the intraosseus pressure in the lumbar spine is identical to, and dependent upon, the pressure in the inferior vena cava. With Valsalva maneuver in the decubitus position, the pressure reaches levels of 90 mm Hg in the inferior vena cava and intraosseus space of lumbar spine.

ISSN:0362-2436    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

The anatomy of the lumbar mamillo-accessory ligament (MAL) was studied by gross dissection in six cadavers. The MAL bridges the mamillary and accessory processes of each lumbar vertebra and encloses the medial branch of the dorsal ramus in an osseofibrous tunnel. The tunnel maintains the proximal course of the medial branch in a constant relationship to bone. This constancy allows for accurate percutaneous techniques to stimulate, anesthetize or destroy the medial branch. The MAL morphologically appears to represent remnants of transversospinal elements in the lumbar region, and is ossified in over 10% of lower lumbar vertebrae. Ossification may interfere with some percutaneous denervation techniques. The MAL may be a site of entrapment of the medial branch and may be a source of low-back pain.

ISSN:0362-2436    

出版商:OVID    

年代:1981

数据来源: OVID