摘要:

In a review of 210 spinal fusions, the platelet count and the arterial–alveolar oxygen tension ratio both decreased as the blood transfused increased, but were not correlated with positive fluid balance. In procedures that might require more than 70–80 ml/kg of blood, such as myelodysplastic, paralytic, and congenital spinal surgery, the coagulation system and arterial gases should be monitored frequently intraoperatively and postoperatively.

ISSN:0362-2436    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

Cadaver bone for spinal fusion operations is as safe as autografts. The author's 35 years' experience using cadaver bone for interbody spinal fusion operations has led to the development of a simplified bone bank method. Unsterile bone removed from young, fresh cadavers is cut into appropriate sizes and shapes, washed clean, packaged and sterilized with ethylene oxide gas, then aerated and stored at room temperature. The results of spinal fusion, both cervical and lumbar, using 187 gas-sterilized bone grafts in 58 patients operated on over the past year and a half, were reviewed and compared with fusions using autografts or banked bone from proven methods. The rate and percentage of fusion of gas-sterilized bone was comparable to other bone grafts with no untoward complications.

ISSN:0362-2436    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

There is considerable confusion and controversy regarding the incidence of radiologic abnormalities, prognosis, and pathomechanics of spinal cord injuries in children. The comparison of mechanisms of injury, severity of trauma, methods of management, and outcome has been very difficult because some authors have used 12 years as the upper age limit, while others have included patients as old as 18 years. This article critically analyzes the neurologic patterns of injury, radiologic features, management, outcome, and pathomechanics in 97 children whose acute spinal cord injury was managed and followed at The Institute for Rehabilitation and Research. Pertinent literature on the subject is also extensively reviewed.

ISSN:0362-2436    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

The Brown-Séquard syndrome is infrequently reported. Though widely considered indicative ofintramedullary spinal cord disease, in the absence of penetrating spinal cord trauma, the syndrome is frequently an early stage ofextramedullary spinal cord compression, as an extensive analysis of diverse literatures reveals. We describe two cases resulting from compression of the spinal cord by a meningioma. While previous reviews emphasize that radicular or vertebral pain is a prominent feature of spinal cord compression by intradural tumors, our patients had no pain referable to tumor. Awareness that painless extramedullary spinal cord compression can produce the Brown-Séquard syndrome, early myelography, and surgical intervention are necessary to prevent progressive deficit. Even when encountered in a patient who has previously well-documented demyelinating disease, the syndrome should not be written off as a relatively untreatable intramedullary process.

ISSN:0362-2436    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

This study was carried out to identify the role of the anterior longitudinal ligament in Harrington distraction rod fixation of the unstable spine, and to suggest clinical means of detecting a ruptured ligament when this is not obvious from a preoperative radiogram. In the unstable thoracolumbar spine, a marked difference in force is required for distraction and stabilization when the ligament is intact compared with when the ligament is disrupted. This can be detected by using a force-indicating distractor during the procedure. Furthermore, when the anterior longitudinal ligament is disrupted, the pattern of vertebral movements during distraction is altered. With the ligament intact, the vertebrae adjacent to the unstable segment will angulate around an axis situated ventral to the vertebral bodies, while the vertebrae will move apart in parallel planes when the ligament is severed. This can easily be detected by studying the movements of Kirschner wires inserted into the spinous processes.

ISSN:0362-2436    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

In bracing of idiopathic scoliosis, the corrective components of the brace have been evaluated regarding axial and lateral forces. The present study stresses the importance of sagittal changes achieved in patients wearing the brace. The corrective effect on scoliotic curves by sagittal changes of the spine in bracing is demonstrated by roentgenograms.

ISSN:0362-2436    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

Based on animal experiments, spinal root anastomoses were performed in two paraplegic patients who had traumatic lesions of the conus medullaris. The aim was to reinnervate the paralyzed urinary bladder. At operation, the functioning T12 nerve roots above the lesion were transected and anastomosed bilaterally to the S2 and S3 ventral and dorsal roots emerging from the injured cord area. About 1 year postoperatively, both patients demonstrated restoration of the micturition reflex as recorded in the cystometrogram. Both patients could feel the urge to void, could initiate micturition voluntarily, and could empty their bladders satisfactorily. The patients' relatively good bladder functions were the result of either regeneration of the newly constructed nervous pathways or spontaneously developed reflex bladders in partial upper neuron lesions.

ISSN:0362-2436    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

Cervical, thoracic, thoracolumbar, and lumbar fractures associated with physiologic complete or incomplete spinal cord injuries frequently have severe soft-tissue injury as well as severe pain associated with the site or area of injury. Transcutaneous electrical neurostimulation has been proved effective in the treatment of various causes of severe acute and chronic intractable pains. We applied this modality to a group of 20 patients who had acute spinal cord injuries and pain associated with severe, extensive soft-tissue injury. Its advantages include ease of application, lack of major complications, increased intestinal peristalsis, and avoidance of narcotic analgesic medications. It also produced significant (greater than 50%) pain relief in 75% of patients treated by transcutaneous electrical neurostimulation.

ISSN:0362-2436    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

The bone mineral content of 109 lumbar vertebrae from 36 different subjects was determined by dual photon absorptiometry. The mean age of the subjects was 58.5 years (range, 31 to 79 years). The ultimate strength of the vertebral bodies was determined during axial compression. Bone mineral content and ultimate compressive strength were correlated (r = 0.86) and the strength was found to increase linearly with increasing amounts of bone mineral content. No differences in this correlation were found in the four vertebral levels (L1–4) included in the study, but a difference in this correlation was found between specimens taken from male and female subjects. The results make it possible to estimate the strength of a vertebral body from the knowledge of its bone mineral content as determined by dual photon absorptiometry and provide a basis for estimations of normal and abnormal amounts of bone mineral content in the vertebrae of the lumbar spine.

ISSN:0362-2436    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

Segmental instability as a consequence of disc degeneration is presented as an entity capable of producing low-back pain which responds to surgical stabilization with spinal fusion, and is illustrated with a case report. Data from lumbar radiographs were analyzed with a computer, and the position changes of the lumbar vertebrae were computed relative to the neutral positions of each. The results indicate that segmental instability is a complex disruption of intervertebral motion, consistent with the coupling behavior of the spine.

ISSN:0362-2436    

出版商:OVID    

年代:1980

数据来源: OVID