[Influence of coexisting pseudo-radicular syndrome on the results of traction treatment in cases of lumbar intervertebral disk hernia]. / Wplyw wspólistniejacego zespolu rzekomokorzeniowego w przypadkach przepuklin ledzwiowych krazków miedzykregowych (plkm) na wyniki terapii trakcyjnej.

105 patients with lumbar disc disease, confirmed by radiculography, magnetic resonance imaging or computed tomography were investigated to evaluate the influence of pseudoradicular syndrome on therapeutic effects. On the basis of characteristic clinical symptoms of radicular and pseudoradicular syndrome patients were divided into two groups: 45 patients with dominant pseudoradicular syndrome and 35 persons with dominant radicular syndrome. All patients underwent clinical examination before and after traction treatment. Clinical evaluation included: the pain syndrome, postural disturbances and nerve root dysfunctions. The effects of the traction treatment were significantly worse in patients with the pseudoradicular syndrome. These results suggest the necessity of differential therapeutic approach in lumbar disc disease patients depending on the predominance of the pathomechanism of disease.

[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).

[The attempt to define reciprocal relations between radicular and pseudoradicular syndrome in patients with lumbar disc herniation (1dh)]. / Próba okreslenia wzajemnej relacji zespolów korzeniowych i rzekomokorzeniowych u chorych na przepukliny ledzwiowych krazków miedzykregowych (plkm).

Based on history and clinical examination in 100 patients with Idh we selected four clinical features characteristic of radicular and pseudoradicular (spondylogenic) syndrome. The choice was based on data from review of literature. We confirmed that pseudoradicular syndrome features appeared in most of Idh patients. Of the 100 patients in 20% pseudoradicular syndrome features prevailed, 14% experienced mainly radicular syndrome features and 66% patients presented mixed clinical picture. We suggest that above relationships should be considered in clinical practice.

[On alleged radicular pain in patients with lumbar intervertebral disc hernias]. / O bólach rzekomokorzeniowych u chorych na przepukliny ledzwiowych krazków miedzykregowych [plkm].

A review is presented of opinions on the sources and mechanisms of pain in patients with hernias of the lumbar intervertebral discs in particular, on the pathogenesis and clinical characteristics of the so called pseudoradicular syndromes in discopathies. The diagnosis of pseudoradicular syndromes reflecting the degree of involvement by the disease process of the osteoarticular and ligamentous spinal structures and the condition of spinal muscles is of importance for the therapeutic management, providing information on the necessity of avoiding rehabilitation procedures contributing to destabilization of the segmental system of the spine (certain types of exercises, exercises in suspension with large amplitude of movements, certain manual procedures) and on the use of procedures reducing the stress on the spine and strengthening it (special positions in bed, isometric exercises, balneotherapy in later stage).

[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.

[Results of radio-anatomic studies of the lumbar spine in patients with intervertebral disk prolapse and in healthy subjects. 1: Vertebrae, disks and intervertebral joints]. / Ergebnisse von radioanatomischen Untersuchungen der Lendenwirbelsäule bei Kranken mit Bandscheibenvorfall und bei Gesunden. Teil 1: Wirbel, Bandscheiben und Zwischenwirbelgelenke.

Radioanatomic research on the vertebrae, intervertebral disks, and joints was carried out in patients suffering from disk herniation. The control group aged 50-60 years had no vertebral pain. Significant differences in the structure of intervertebral disks were observed. The height of intervertebral disks in the patients was (statistically) significantly smaller than in the control group. In some of the patients the signs of micro-, aniso-, and poikilospondylia were observed in the lumbar spine. Asymmetry of intervertebral joints was found 4 times more frequently in the patients than in the control group. The spinal anatomic changes in both groups occurred most often and to the greatest degree in the 3 lowest lumbar segments. This is the area most frequently affected by disk herniation. The author believes that this proves a causal relation between dysplastic spinal type and disk herniation.

[Results of radio-anatomic studies of the lumbar spine in patients with intervertebral disk prolapse and in healthy subjects. 2: Spinal canal and intervertebral foramina]. / Ergebnisse von radioanatomischen Untersuchungen der Lendenwirbelsäule bei Kranken mit Bandscheibenvorfall und bei Gesunden. Teil 2: Wirbelkanal und Zwischenwirbellöcher.

Radioanatomic research on the spinal canal and intervertebral foramina was carried out in 225 patients suffering from disk herniation. The control group numbered 50. Statistically significant differences in spinal canal structure were observed, showing smaller lumina in most patients, and in some also an irregular course along the long axis. The anteroposterior diameter (width) of the intervertebral foramina was also smaller in the patient group. The most evident anatomic differences appeared in the lower lumbar segments, i.e., the area most affected by intervertebral disk herniation. This suggests a relation between the type of spinal structure and the tendency to disk herniation.

[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.

[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.