ABSTRACT
The authors present a case in which electrical injury to the central nervous system resulted from uncontrolled activation of a cervical spinal cord stimulation device by an antitheft device. The injury resulted in long-term neurological sequelae.
Subject(s)
Electric Injuries/etiology , Electric Stimulation Therapy/instrumentation , Electromagnetic Phenomena/instrumentation , Pain, Intractable/therapy , Security Measures , Spinal Cord Injuries/etiology , Spinal Cord , Aged , Ataxia/etiology , Dysarthria/etiology , Electric Stimulation Therapy/adverse effects , Equipment Failure , Follow-Up Studies , Gait , Humans , Male , Memory Disorders/etiology , Neurologic ExaminationABSTRACT
Eleven patients with metastatic disease of the spine underwent anterior resection and stabilization with a new cancellous metal, keystone-shaped construct. Three are alive 1 year following surgery and seven at 6 months. One patient died postoperatively of pulmonary insufficiency. Ambulation was improved in all survivers. There was no dislocation of the construct.
Subject(s)
Prostheses and Implants , Spinal Neoplasms/secondary , Aged , Aged, 80 and over , Humans , Metals , Methods , Middle Aged , Radiography , Spinal Neoplasms/diagnostic imaging , Spinal Neoplasms/surgeryABSTRACT
We report our experience with sacroiliac joint arthrodesis in cases of overt osteoarthritis. Twenty-two operations were performed over a period of 3.5 years and reviewed between 12 and 55 months postoperatively. The clinical picture and diagnostic steps are discussed. We conclude that if the selection of patients is strict we can expect 70% satisfactory results.
Subject(s)
Arthrodesis , Back Pain/surgery , Sacroiliac Joint/surgery , Adult , Back Pain/etiology , Female , Humans , Male , Middle Aged , Osteoarthritis/complications , Osteoarthritis/surgeryABSTRACT
We report on eight cases in which ceramic implants were used to replace bone grafts. The results of this pilot study show definite usefulness of tricalcium phosphates, whereas hydroxyapatite did not prove suitable.
Subject(s)
Biocompatible Materials , Bone Plates , Ceramics , Prostheses and Implants , Adult , Arthrodesis , Calcium Phosphates , Durapatite , Evaluation Studies as Topic , Humans , Hydroxyapatites , Middle Aged , Pilot Projects , Spinal FusionABSTRACT
Nineteen patients with chronic pain due to a traumatic peripheral neuropathy were treated by means of implanted nerve stimulation. In 11 (58%) pain was completely relieved and in four (21%) it was reduced sufficiently to discontinue analgesics. The average follow-up was 11.5 months. The technique is described and the failures discussed. The necessity for implanting the stimulator proximally is emphasised.
Subject(s)
Electric Stimulation Therapy/methods , Pain Management , Peripheral Nervous System Diseases/complications , Adult , Aged , Chronic Disease , Electric Stimulation Therapy/instrumentation , Female , Humans , Male , Middle AgedABSTRACT
Sixteen patients suffering from pain due to a "battered" root syndrome (BRS) [1] were treated with spinal cord stimulation (SCS). All patients had undergone spinal surgery and complained of severe intractable radicular pain. The myelograms revealed an amputated root, the computerized tomograms showed periradicular scar tissues, electromyograms and/or sensory evoked potentials showed pathological changes. Electrical root stimulation via an indwelling, Teflon-coated needle reduced pain significantly within 30 min (80-100 Hz, 0.2-0.3 V). Root blocks with 1 ml bupivacaine (0.5%) abolished the patient's pain completely. No patient revealed major psychosomatic or psychosocial problems. Employing this patient selection schedule, 75% of the patients were pain-free after a mean follow-up period of 16 months range 6-30.
Subject(s)
Electric Stimulation Therapy , Spinal Nerve Roots , Adult , Female , Follow-Up Studies , Humans , Male , Middle Aged , Peripheral Nervous System Diseases/therapy , Spinal Cord/physiopathology , Spinal Nerve Roots/physiopathology , SyndromeABSTRACT
The authors classify the three types of chronic pain in paraplegics: lesional area pain, projected pain, and triggered pain. The clinical description and proposed treatment for each type of pain are discussed.
Subject(s)
Pain/etiology , Paraplegia/physiopathology , Spinal Cord Injuries/physiopathology , Chronic Disease , Humans , Pain/physiopathology , Sensation/physiology , Spinal Cord/physiopathologyABSTRACT
The U.Q.S. is clinically described and a working hypothesis of its possible pathogenetic pathways is forwarded. The A.C. and R.H. joints were found to be the trigger points in six cases. All were pain free following joint resection surgery.
Subject(s)
Acromioclavicular Joint/surgery , Elbow Joint/surgery , Joint Diseases/surgery , Adult , Aged , Humans , Middle Aged , Pain/physiopathology , SyndromeABSTRACT
Serum lipoprotein electrophoresis and other laboratory tests were made on 14 injured patients over 10 days. Reduction in the pre-beta fraction to an average of 6 per cent, with an elevation of the alpha lipoprotein fraction to an average of 41 per cent, were recorded. The patients without complications regained their normal lipoprotein pattern within 48 hours, while in the two cases who developed fat embolism, the deranged pattern lasted for up to 10 days. The clinical diagnosis of fat embolism is based on signs that appear generally within 3 days following injury. As prognosis depends on early diagnosis, in order to start treatment before full blown clinical signs are present, there is the need for a laboratory test which gives early results and is reliable and easy to perform. This study shows an apparently distinct pattern of the serum lipoproteins which may provide us with a warning about which patients are at risk of developing fat embolism.
Subject(s)
Embolism, Fat/blood , Fractures, Bone/blood , Fractures, Closed/blood , Lipoproteins/blood , Adolescent , Adult , Aged , Blood Protein Electrophoresis , Electrophoresis, Agar Gel , Embolism, Fat/etiology , Female , Femoral Fractures/blood , Fractures, Closed/complications , Humans , Lumbar Vertebrae/injuries , Male , Middle Aged , Pelvic Bones/injuries , Tibial Fractures/bloodABSTRACT
We present in this report the operative method we have used in 7 cases of fracture-dislocation of the lower cervical spine. The technique includes partial resection of the fractured vertebral body, removal of the adjacent discs, excision of posteriorly displaced bone and disc and anterior interbody fusion between the three vertebrae. The latter is performed using a cortico-cancellous graft taken from the iliac crest and further stability is achieved by a small AO plate. All the cases started motion 48 hours after operation without further external support. Although 6 of the cases showed neurological improvement, this cannot be at this stage attributed to the surgical treatment. Nevertheless, none was made worse by the operation.
Subject(s)
Cervical Vertebrae/injuries , Fractures, Bone/surgery , Spinal Fusion/methods , Adolescent , Adult , Female , Humans , Male , Middle Aged , TractionABSTRACT
We have performed intra-osseous venography on 22 patients with chondromalacia patellae or patellofemoral osteoarthritis. Venous engorgement of the patella was demonstrated in both conditions regardless of the severity of the pathological changes.
Subject(s)
Femur/blood supply , Osteoarthritis/diagnostic imaging , Patella/blood supply , Phlebography , Adult , Cartilage Diseases/diagnostic imaging , Female , Humans , Male , Middle AgedABSTRACT
Thirteen patients with chondromalacia Stages 1, 2, and 3 and with patello-femoral osteoarthritis were treated by anterior displacement of the tibial tuberosity and followed for 22 to 33 months. Rated on a scale of objective anatomic and clinical criteria, the results were satisfactory in 85% of the patients. These results corroborate reports of other authors concerning this operation.
Subject(s)
Knee Joint/surgery , Osteoarthritis/surgery , Patella/surgery , Adult , Female , Follow-Up Studies , Humans , Male , Methods , Middle AgedABSTRACT
A high medial release operation for resistant clubfoot is described. The method appears to be safe, has a low recurrence rate, and is not associated with postoperative stiffness of the foot.
Subject(s)
Clubfoot/surgery , Child, Preschool , Female , Humans , Infant , Leg/surgery , Male , MethodsSubject(s)
Mass Screening , Scoliosis/epidemiology , Adolescent , Child , Female , Humans , Israel , Male , School Health ServicesABSTRACT
A method of external fixation is presented which has been applied in 8 patients with a fracture of the humeral shaft. The indications and technique are described.
Subject(s)
Fracture Fixation , Humeral Fractures/surgery , Adolescent , Adult , Aged , Female , Fracture Fixation/adverse effects , Humans , Humeral Fractures/diagnostic imaging , Male , Middle Aged , Paralysis/etiology , Radial Nerve/injuries , Radiography , Wound HealingABSTRACT
A case of fracture-dislocation of the hip with loss of bone from the proximal part of the femur due to a war injury is described. It is concluded that a total hip arthroplasty after 3 months is a suitable treatment.
