摘要:

The study that received the 1984 Volvo Award in Clinical Science was published in SPINE as a two part report by Wiesel et al (Spine9:549–551, 1984) and by Bell et al (Spine9:552-556, 1984), giving the readership an unimpeded view of the work of these unimpeachable investigators. In reaction, the readership submitted a cluster of letters from diverse sources challenging certain aspects of the report. To guarantee an impartial airing of these alternate views, Spine published these letters in an Editorial (Spine10:691–695,1985) without first presenting them to the authors of the Volvo Award papers. This action was taken to grant the letter writers free expression in their own space and is considered appropriate in light of the fact that the Editor-in-Chief ofSpinesits on the Volvo Award Committee where he is free to vote as his judgement dictates. However, as an editor he cannot infer that publication of a work is tantamount to an endorsement, since this would demean the impartiality required to the position. In due course, the authors of the Volvo Award papers at issue have responsed to the Editorial, andSpineherewith provides them with unfettered space to voice their position. Please note that the letter of Dr. Wiesel to Dr. Raskin was his response only to Dr. Raskin's comments. Dr.Wiesel's response to the entire group of letters is included with those of his co-authors. In these times of high technology, there must be both broad and deep discussion of each new advance to establish a proper perspectiveSpinecontinues to offer itself as a forum for such exchange.

ISSN:0362-2436    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

In a population based sample, 550 of 619 people with fatal and nonfatal spinal cord injuries were classified according to the cause of injury and according to the anatomic location of the highest spinal cord injury. Motor vehicle occupants accounted for 42% of the people with spinal cord injuries. Sixty percent of those injured had a cervical cord injury, 25% a thoracic cord injury, and 15% a lumbosacral cord injury. The specific anatomic locations most commonly injured were at C1 (12% of all spinal cord injuries), C6 (9%), and L2 (5%). The anatomic site of injury was significantly (P< 0.001) related to the cause of injury. Thirtyseven percent of the spinal cord injuries from firearms and 97% of those from diving were located in the cervical cord. In contrast, 68% of spinal cord injuries to motor vehicle occupants were cervical; 17% at C1. The distribution of injuries among drivers was similar to that among other occupants.

ISSN:0362-2436    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

In an attempt to enhance theimmediatestability of posterior interspinous fusion constructs, the authors conducted the following project. Twenty-four adult mongrel dogs underwent a posterior C4–C5 fusion using iliac crest autogenous graft and internal fixation using either ulna struts (12) or metallic struts (12) fixed into position by sublaminar wires. Half of the animals were killed at either 1 week or 3 months postoperatively, and their C4–C5 motion segments were excised and studied radiologically, mechanically, and histologically. Both fusions created immediate and 3-month stability equivalent or superior to normal C4–C5 canine spinal segments. However, three dogs were rendered completely and two dogs incompletely quadriplegic by the surgery. Clinical Relevance: Because of the relatively high rate of neurologic injury associated with these procedures in normal dogs, the authors hesitate to endorse their use in all but complete quadriplegic patients.

ISSN:0362-2436    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

A group of surgeons who used the Galveston technique for L-rod instrumentation (LRI) were surveyed to learn their experience with associated neurologic injuries. Among 507 LRIs for scoliosis there were two partial cord syndromes (0.4%), 13 “nerve root hyperesthesias” (2.6%), and two other nerve injuries (0.4%). All patients, except one with mild residuals after a partial cord injury, fully recovered from their neurologic problem. Experience in spinal surgery, education about LRI strategies and techniques, hands-on technical instruction, and use of an established process for LRI are believed to be the factors that enabled these surgeons to perform this complex procedure with relative safety.

ISSN:0362-2436    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

Twenty-two patients with major lumbar or thoracolumbar curves were treated with Zielke's modification of the Dwyer instrumentation, termed the “ventral derotation spondylodesis (VDS) system. In 16 patients, this was followed by planned second-stage posterior Harrington instrumentation and fusion. Six patients with adolescent idiopathic scoliosis were treated with VDS instrumentation and fusion alone. In neuromuscular and adult idiopathic scoliosis, a combined approach resulted in excellent curve correction and a high rate of successful fusion. In adolescent idiopathic scoliosis, VDS instrumentation alone resulted in excellent curve correction while permitting a shorter fusion length than conventional posterior Harrington instrumentation.

ISSN:0362-2436    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

Arteriovenous malformations (AVMs) of the spinal cord are a rare occurrence in the pediatric age group. This report describes the successful, complete removal of such a lesion in a boy age 12. The clinico-radiological findings and different treatment modalities of these entities are reviewed.

ISSN:0362-2436    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

With increasing use of chemonucleolysis, interest and use of discography is at an all-time high. Various reports in past years have disagreed on the safety and efficacy of intradiscal injections of contrast mediums. This experimental study was devised to determine the effects of discography on the gross and histologic appearance of the lumbar intervertebral disc. Through a laparotomy approach, five lumbar discs in ten dogs were exposed. In each dog, one disc served as a control, another punctured with a needle, and the others injected with metrizamide, hypaque, or saline, At 2,4,6,8, and 10 weeks postoperative, two dogs were killed at each time interval. Examination of the discs revealed no gross differences between any of the groups. The normal gross architecture of the concentric annulus and gelatinous nucleus was maintained in all specimens. This study found no evidence that discography results in gross or histologic damage to the intervertebral disc. It does not appear that discography will predispose a normal intervertebral disc to herniate. Discography alone appears to be a safe diagnostic procedure with no experimental evidence of any untoward gross or histologic effects.

ISSN:0362-2436    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

Because patient satisfaction with medical care for back pain is an important outcome and may correlate with compliance or other outcomes, the authors devised a brief (9- item) satisfaction scale and demonstrated its reliability and validity. The most frequently cited source of dissatisfaction among 140 patients with mechanical low-back pain (LBP) was failure to receive an adequate explanation of the problem. Compared with patients who reported an adequate explanation, those who did not wanted more diagnostic tests, were less satisfied with their visit, and were less likely to want the same doctor again. Receiving an adequate explanation was not associated with more tests or physician time. Thus, explanation of symptoms has a high priority among patients with LBP, and this need should be explicitly acknowledged and addressed by their physicians.

ISSN:0362-2436    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

Intra- and intertester reliability of a previously described technique for measurement of sagittal plane lumbar spine motion was assessed. Results demonstrated a high degree of reliability of this technique. Sagittal plane norms for men and women are also presented. In addition, a pilot study of a simplein vivomeasurement method for lumbar torsion is described and tested on a group of control subjects and a group of chronic low-back pain patients.

ISSN:0362-2436    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

The present article reviews the use of psychologic measures in guiding a functional restoration treatment program with chronic low-back pain patients. The results of the first 134 consecutive patients completing this program are reviewed. These results demonstrate that various psychologic measures paralleled improvement in physical function. Of particular interest is the finding that various Minnesota Multiphasic Personality Inventory (MMPI) scales that were initially clinically elevated showed a significant decrease to nonelevated levels after treatment. The clinical implications of these findings are discussed, along with the important observation that one should avoid assuming that a single psychologic test can reliably be used as the sole predictor variable in clinical cases.

ISSN:0362-2436    

出版商:OVID    

年代:1986

数据来源: OVID