摘要:

The infra-aortic spinal arteries caudal to the aortic bifurcation were Studied in 20 perinatal and adult cadavers to determine their irnport relative to eKtraforamlrcal ap-prooshfls to trie lower lumbar discs as well as their probable irvolwa.nQ.it Fn certain cases of radiculomsd-ullary ischemia. Analysis of these specimens indicated that, despite considerable variation, the arteries to the L4-L5 and L5-S1 intervertebral foramens generally ware not related to the disc dorsolateraI zones where lateral surgical approaches are best accomplished. Also, the frequency in which the fourth as well as the fifth lumbar and all sacral segmental vessels were dependent on the posterior division of the hypogastric artery may help explain how spinal cord ischemia could occur in individuals with vulnerable cord vascular patterns and/or spinal arteriopathy after interruption of hypogastrie artery blood flow during pelvic operations.

ISSN:0362-2436    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Anatomic and rediographic studies were made to investigate normal variation of dorsal root ganglia in lumboaacral roots. The spinal nerves could be divided into two groups, with and without bifurcation of ventral nerve root and dorsal root -ganglion. The bifurcated group was further classified into three types, L4 end L5 nerve roots were all bifurcated, and S1 were all nonbifurcated. The positions of dorsal root ganglia were classified into three types: intraspinal, intraforaminal, and extraforaminal. At L4 and L5 nerve roots, they ware mostly intraforaminal, whereas at S1, they were mostly intrespinal. Preximally placed ganglia hadahigh frequency of ganglionic indentation, The incidence of in-traspinal dorsal root ganglia was much higher clinically than in anatomic studies. Variations in connecting patterns or positions of dorsal root ganglia may be related to the occurrence and variety of radicular symptoms. The dorsal root ganglia is clinically important and its location may correspond to clinical symptoms,

ISSN:0362-2436    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

One thousand two hundred patients (600 women and 600 men) aged 18 to 72 years ware referred for computed tomographic examination of the lumbosacral spine (L3-S1) after low-back pain or sciatica. Patients with spinal abnormalities other then spina bifida occulta (SGOI-S1 and findings other than posterior herniation of intervertebral disc were not included in this study, All of the patients underwent conventional radiographs of the lumbosacral spine. The incidance of SBO-S1 was higher In younger age groups and decreased with age Patients with SBO-S1 showed a higher incidence of posterior disc herniation, which increased with age. This can be explained by instability of the base of the lumbar spine caused by SBO-S1, which produces a predispostion to posterior disc herniation. The results were statistically significant.

ISSN:0362-2436    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

It is widely believed that brain stem dysfunction and cranlal nerve palsies in patients with rheumatoid arthritis (RA) are common and related to the vertical transiocation of the odontoid process. In our database of 235 patients with seropositive RA and craniocervical junction involvement, we have found a very low incidence of such problems. Long tract sings were common, but loss of propriception (joint position sensation) as the sole neurologic deficit was rare. Nystegmus was found to be associated with the tonsillar herniation of a Chiari 1 malformation and loss of joint position sensation with severe compression of the posterior aspect of the spinal cord at the craniocervical junction, particularly by sublaminar wiring, are discussed.

ISSN:0362-2436    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Dissociated motor lose due to cervical spondylosis and disc herniation was evaluated in 10 patients who presented with left deltoid paresis In the absence of sensory deficits or myelopathy. All of these cases underwent cervical anterior decompression. Based on magenetic resonance imaging, computed tomography myelography, and computed tomography discography, patients were divided Into two pathologic types; The first showed focal bony spur and disc herniation with axial cord rotation and nerve root compression, and the second demonstrated ventral cord flattening. Electrophysiologic studies included evoked spinal potentials, motor evoked potentials, and evoked muscle action potentials. Motor evoked potentials, recorded epidurally from the ventral aspect of the thecal sac and the nerve root within the anterior discectomy or vertebrectomy sites, proved clinically most useful. Combining the latest available neuroradiologic and electrophysiologic information, 4 types of neural injury associated with deltoid pareses were Identified in the 10 patients. The first included isolated C5 nerve root lesions; the second, C6 nerve root lesions; the third, both C5 and CS nerve root leaions, and finally, intrinsic card pathology.

ISSN:0362-2436    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

The ability of Elvey'5 “brachial plexus tension test” to identify pain referred from the cervical region was investigated in 50 patients with unilateral shoulder and upper arm pain: 25 reported symptoms commencing after open heart surgery, indicating a high probability of referred pain due to that procedure; 25 were athletes with injuries from throwing movements, a cause appearing much less likely to cause referred pain. Twenty-five asymptomatic subjects with no history of spinal or limb pain also were tested. Cervical and upper limb maneuvers of the lest were assessed goniometrically. The cardiac group showed significantly greater test results than those of the other groups, suggesting that the test is able to discriminate referred and local sources of upper limb pain.

ISSN:0362-2436    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Intraoperative spinal ultrasonography (IOES) was used to evaluate and monitor the spinal cord in 49 patients with cervical myelopathy. Intraoperative spinal ultrasonography demonstrated movements of the dura mater and the spinal cord at the cardiac rate, with some variability in intensity and mode, It also delineated the anterior surface of the spinal canal and configuration of the spinal card. Statistical analysis showed no correlation between clinical outcome and morphologic restoration, and between clinical outcome and variations in intensity or mode of the pulsatile spinal cord movements. Spinal cord motions were surmised to be generated not only by the anterior spinal artery, but also by other factors. Dural pulsations clearly did not always imply the absence of compression of the spinal cord, Intraoperative spinal ultrasonography was thus quite useful for monitoring decompression in cervical myelopathy.

ISSN:0362-2436    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

The SCL-90-R has became an increasingly popular measure of maladjustment. Its use beyond simply screening chronic low-back pain (CLBP) patients has been criticized, however, In part, because It appears to be a single-factor instrument. In fact, its nine major scales do share only one important common factor, i.e., general psychological discomfort. The scale most applicable to CLBP, however, somatization (SOM), has sufficient specific variance that it does not simply measure discomfort and predicts several other measures better than the SCL-90-Rs more reliable composite measure (GSI). Using SOM in conjunction with the GSI to separate psychological from physical discomfort is therefore both clinically and psychometrically appropriate. Other objections to the test are critically evaluated. The potential clinical relevance of the SCL-90 R is discussed.

ISSN:0362-2436    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

The purpose of this study was to assess repeated exercise on the B-200 isostation as part of rehabilitation work tolerance for nonsurgical patients with lumbar spine disorders. For a consecutive 7-month period, treatment subjects were randomly assigned according to birth date for participation in two groups: a standard work tolerance program only or standard work tolerance program plus inclusion of exercise on the B-200 isostation. Each patient had similar referral diagnosis requiring conservative treatment. Treatment groups were compared with a control population of volunteers who had neither back pain nor known underlying spinal pathology. All study patients had objective measurement of range of motion, isometric strength, and velocity of motion, on the B-200 isostation before treatment and at follow-up 3 weeks after treatment. The data showed no significant difference of percent improvement when comparing patients in either of the randomized assigned treatment groups. There was a higher percentage of improvement for each treatment group as compared with the control individuals, however, Based on our study using the B-200 isostation, there is little objective justification for including exercise on the B-200 dynametric isostation as part of the rehabilitation routine for improvement of functional physical capacity.

ISSN:0362-2436    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

The percutaneous treatment of lumbar disc disease with laser energy has emerged recently as an alternative to open surgical or even mechanical percutaneous methods. Although numerous laser wavelengths have been employed in birth the experimental and clinical settings, no consensus exists regarding selection of laser, treatment duration, or energy requirements. Inspection of the disc/water absorption spectrum combined with the limitations of the fiberoptic delivery systems argue for the use of lasers near 2.0 μm. such as the 2.1-μm Ho:YAG. Although racently developedin vitromodels have allowed for laser system comparisons, most clinical work has been empiric uncontrolled, and in very small series.

ISSN:0362-2436    

出版商:OVID    

年代:1994

数据来源: OVID