[The significance of radiculography and resonance tomography in the diagnosis and treatment of lumbar discopathy]. / Znaczenie radykulografii i tomografii rezonansowej w rozpoznawaniu i leczeniu dyskopatii ledzwiowej.

The subject of the study was an assessment of the usefulness of radiculography and resonance tomography in the diagnosis of lumbar discopathy. The study was carried out in 100 cases of lumbar discopathy treated at the Department of Spondyloneurosurgery Institute of Rheumatology in Warsaw. Both radiculography and resonance tomography were found to be of equal diagnostic value in the verification of the clinical symptoms of this discopathy. The detection rate of lumbar discopathy by both methods was much higher than based on clinical symptomatology alone. The use of both methods was not equivalent diagnostically (often they replace one another, but often also they supplement one another), and for that reason combined examination by both methods is frequently of high importance in practice, when the line of management is to be set down.

[The assessment of therapeutic effectiveness of paravertebral blockades in patients with painful radicular syndromes in discopathy and in lumbar spine spondylosis]. / Ocena efektywnosci terapeutycznej blokad przykregoslupowych u chorych z zespolami bólowo-korzeniowymi w przebiegu dyskopatii i zmian zwyrodnieniowych ledzwiowego odcinka kregoslupa.

A group of 103 patients were examined for radicular painful syndromes in lumbar discopathy and lumbar spondylosis. Fifty-eight were treated by placing them in spine-decompressing position, traction and therapeutic exercises. The group of 45 patients had additionally paravertebral blockade (steroid + a local anaesthetic). In the blockade group the therapeutic effects were better, with rapid reduction of acute pain, with wellbeing improvement and better comfort, which facilitated further stages of the treatment. This made possible shortening of hospital stay by 20%, on average, as compared with the group without blockade. In patients with shorter lasting radicular pains (below 2 months) the results after paravertebral blockade were significantly better than in cases with longer duration of pains (2-6 months).

[Prognostic value of evoked potentials of the spinal cord in surgical treatment of lumbar intervertebral disk prolapse]. / Prognostyczne znaczenie wywolanych potencjalów rdzeniowych w chirurgicznym leczeniu ledzwiowych przepuklin krazkowych.

Spinal potentials were evoked stimulating the peripheral nerves of lower extremities in healthy people and in patients with manifestations of lumbar disc prolapse. The patients were studied before and early after the operation. In healthy subjects the velocity of impulse conduction was nearly identical when both extremities were compared. In the patients the test before the operation revealed a significant prolongation of the latency of the potentials on the side of the damaged nerve root. After the operation a significant difference between the healthy and the affected side was still present early after the operation but it was significantly smaller than before the operation since the conduction velocity was improved on the side of the operation. The study of spinal evoked potentials makes possible recognition of disturbed function of nerve roots, and after the operation the rate of changes of potential latency is an important prognostic sign.

[Backache in adept teen-agers in occupations producing spinal strain--morbidity, predisposition]. / Bóle krzyza u mlodocianych adeptów do zawodów wywolujacych przeciazenie kregoslupa--zachorowalnosc, predyspozycje.

In total 1,149 pupils of the III class of the mechanical, metallurgical, building, power engineering and chemical vocational schools were examined. Backache was diagnosed in 50 cases while the same ailment in parents or siblings were diagnosed in 148 cases, i.e. 17.2%. Percentage of persons with congenital spine disorders (low intervertebral disc, narrow spinal channel, segmentation disorders spondylolysis, and asymmetry of intervertebral joints) was estimated as 30%. Such disorders predispose to backache. A risk of backache in the group under study was estimated however as 50% of pupils preparing for professions producing significant overload to the spine. Possibilities and difficulties of the proper classifications of candidates to such vocations are discussed.

[The etiology of lumbago after surgical treatment of lumbar intervertebral disk prolapse]. / Przyczynek do etiologii postrzalu (lumbago) po operacjach ledzwiowych przepuklin krazkowych.

Three patients are reported in whom on days 10-14 after the operation for lumbar intervertebral disc prolapse symptoms of lumbago developed. In all cases radiological examination revealed signs characteristic for spondylodiscitis. The analysis of these cases and other ones collected from the literature suggested the conclusion that spondylodiscitis occurring after operations for lumbar disc prolapse is a self-limiting infection in the development of which a role may be played, apart from bacterial factors also by immunological mechanisms.

[A case of neurilemmoma of the L5 spinal nerve root with a clinical and radiculographic picture of intervertebral disk prolapse]. / Przypadek nerwiaka oslonkowego korzenia nerwowego L5 o obrazie klinicznym i radykulograficznym przepukliny krazka miedzykregowego.

The authors describe a case of neurilemmoma of a nerve root with clinical and radiological manifestations of intervertebral disc prolapse.

[A case of Tarlov's subarachnoid cyst with a peculiar clinical course]. / Przypadek torbieli pajeczynówkowej Tarlova o osobliwym przebiegu klinicznym.

The authors describe a case of a fairly large subarachnoid cyst at the S1 nerve root which compressed and damaged the neighbouring L5 root at the intervertebral foramen. After surgical removal of the cyst the signs of damage to the L5 root regressed.

[Clinical picture of diskopathy in patients with narrow lumbar spinal canal]. / Obraz klinikczny dyskopatii u chorych z waskim kanalem kregowym odcinka ledzwiowego.

In a group of 400 patients operated upon at the Department of Neurology, Institute of Rheumatology in Warsaw in the years 1971-1978 for lumbar intervertebral disc prolapse in 20 cases (5%) canal stenosis was found as the cause of vertebral canal narrowing. Three clinical syndromes were isolated in this group: cauda equina intermittent claudication (4 cases), flaccid paraparesis of lower extremities (3 cases) and ischialgia with paralysis of an extremity (13 cases). The clinical and radiological features and pathogenetic factors in stenosis of the lower part of the vertebral canal are discussed. The good results of vertebral canal decompression are stressed.

[Evaluation of the results of conservative and surgical treatment of lumbar diskopathy]. / Katamnestyczna ocena wyników zachowawczego i chirurgicznego leczenia dyskopatii ledzwiowego odcinka kregoslupa.

The authors analysed 300 inquiry responses from patients with lumbar discopathy treated conservatively and surgically at the Department of Neurology, Institute of Rheumatology in Warsaw in the period from Jan 1 1971 to Dec 31 1976. A significant proportion of patients (86%) reported a good result of this treatment persisting for many years. Seventy-five per cent of patients treated here returned to their previous occupation. In a comparative analysis of the conservatively and surgically treated cases the results of surgical treatment were found to be evidently better which suggests a need for extending the indications to surgical interventions. The authors conclude that effective conservative or surgical treatment in hospital has an additional favourable psychological influence on the patients, and maintenance of good therapeutic results many years after hospital treatment depends on posthospital systematic medical care which influences the further fates of the patients.

[Case of non-ossifying fibroma (fibroma non osteogenicum, fibroma non ossificans) situated in the cervical spine]. / Przypadek "wlókniaka niekostniejacego" (fibroma non osteogenicum, fibroma non ossificans), umiejscowionego w szyjnym odcinku kregoslupa.

A case of a neoplasm called non-osteogenic fibroma or non-ossifying fibroma is reported. The neoplasm was situated in the cervical part of the spine and was removed surgically. A peculiarity of this case is rare occurrence of this neoplasm and oligosymptomatic stationary course of the disease.

[Usefulness of epidurography in the diagnosis of pathological changes in the vertebral canal]. / Przydatnosc epidurografii w rozpoznawaniu patologii kanalu kregowego.

The authors evaluated 60 epidurographies performed in patients with suspected compressing lesions in the vertebral canal. It was demonstrated that epidurography may be a useful method for diagnosis of pathological conditions in the vertebral canal, particularly in its thoracolumbar part. In many cases this method is sufficient for establishing full diagnosis, not infrequently it should be applied as a supplementary procedure (e.g. for evaluating the structure of the vertebral canal or for accurate assessment of the size of the tumour situated in the canal) and in cases with high-grade stenosis of the canal it is the method of choice. Moreover, it was found that epidurography is a method of low invasiveness, not harmful and well tolerated by the patients.

[Varicosity of the lower part of the vertebral canal]. / Zylakowatosc dolnego odcinka kanalu kregowego.

In a group of 300 patients with the diagnosis of lumbar nucleus pulposus prolapse treated surgically the authors found in 4 cases not the expected prolapse but varicose blood vessels surrounding the nerve roots and immobilizing them in adhesions. In another 5 patients vertebral canal varicosities were associated with nucleus pulposus prolapse. None of these cases of vertebral canal varicosities had been diagnosed before operation since the clinical state of these patients was not significantly different from the state of patients with nucleus prolapse and radiculography failed to supply sufficient diagnostic data or suggested presence of small prolapse. An auxiliary diagnostic finding in cases of vertebral canal varices may be frequent association of spinal anomalies (in 3/4 of the observed cases) and obesity (in 2/3 of cases). Surgical decompression of vertebral canal and liberation of roots from adhesions without excision or ligation of varicose veins gave good therapeutic results.