Posterior Lumbar Interbody Fusion

The authors present 4 cases of spondylolisthesis, 1 case of spondylolysis and 2 cases of Tbc spondylitis of lower lumbar spine treated by posterior lumbar interbody fusion, with follow-up periods of 3 months to 2 years. All cases had severe low back pain. Other common manifestations were radiating pain to leg. All cases were treated with laminectomy, which included a mesial facetectomy followed by posterior lumbar interbody fusion. The spondylolisthesis was reduced to zero degrees in three cases by the use of vertebral spreader. The fusion rate of intervertebral space in radiological finding was 100%. On case become pain free, 4 cases had mild degree of pain, 1 case had moderate degree of pain and 1 case was not improved. The authors conclude that posterior lumbar interbody fusion is applicable as a surgical treatment of patient with spondylolisthesis and Tbc spondylitis.

Clinical Aspect of Fixation with Harrington Rods of Unstable Thoraco . Lumbar Spine Fracture and Fracture-Dislocation

From January, 1984 to January, 1985 twelve patients with unstable fracture and fracture-dislocation of the thoraco . lumbar spine with neurologic deficits were treated with Harrington Instrument. Fixation by Harrington Instrumentation appeared to provide stabilization, reduction and return of neural function. Author performed Harrington Instrumentation with experience of 12 cases of unstable thoraco . lumbar spine fructure and fracture-dislocation with neurologic deficits. Results were as follows : 1) Spinal fracture and fracture-dislocation were most common in thoraco . lumbar Junction. 2) Harrington Instrumentation was very effective for keeping the spine stability in unstable fracture. 3) Six cases (50%) had a complete neurologic deficit and six cases (50%) had a incomplete neurologic deficit, two cases of the six patients with complete neurologic deficits recovered slightly but two cases with incomplete neurological deficit gained complete recovery. 4) During the postoperative period, early ambulation was possible and average admission period were 71 days. 5) Correction of spinal deformity. A. Average value of kyphotic angle (12.5 degrees). B. Average value of Iw(Index of weding) (1.32). C. Displacement was completely corrected in eight patients (100%).

Relationship between Pressure Response to Repeated Elevation of Intracranial Pressure and Central alpha-Adrenoceptor in Rabbit

It is well documented that elevation of intracranial pressure is accompanied by arterial blood pressure(cushing response) in laboratory animals as well as in human. When the elevation of intracranial pressure(ICP) was repeated in a rabbit at an interval of 30-60 min, the blood pressure increased more promtly than in the first elevation of ICP, suggesting that mechanism involved in the pressure might be different. Therefore, this study was undertaken to clarify the pharmacological characteristics of the response to the first and repeated(second) elevation of ICP in urethane anesthetized rabbits. Increasing ICP, induced by infusion of saline into a ballooned in the epidural space, produced arise of the arterial blood pressure. When the blood pressure reached a peak, the balloon was suddenly deflated to reduced the ICP and blood pressure declined (the first ICP elevation experiment). After 30-60 min the same procedure was repeated (the second ICP-elevation experiment) Results are summarized as follows; 1) In the first ICP elevation experiment, the arise of ICP was relatively slow at the beginning of the infusion but became sharp as the infusion proceeded. When ICP increased sharply BP also increased abruptly and heart rate decreased. 2) In the second ICP elevation experiment, the slight decrease in BP which appeard at the beginning of the first ICP elevation experiment rat observed, so that only an abrupt arise of BP was seen. 3) Intravenous chlorisondamine inhibited the pressure responses in the second ICP elevation experiment. 4) Intraventricular corynanthine had little effect on the pressure response to the first ICP elevation but inhibited the pressure response to the second ICP elevation. 5) Intraventricular clonidine, yohimbine and prazosin little effect on the pressure response to the second ICP elevation. From this results that functional integrity of central alpha 2-adrenoceptor which took part in the pressure response to the first ICP elevation might have deranged in the second ICP elevation and that central alpha 1-adrenoceptors play a dominant role in the pressure response to the second ICP elevation.