Scientific Idea of Professor Marian Weiss.

This year marks the 100th birth anniversary of Professor Marian Alan Weiss. The following article serves as a reminder of this magnificent man, doctor and scientist and his indisputable multifaceted accomplishments. Prof. Weiss was a brilliant organizer. He proposed and then formed the largest medical rehabilitation centre in Poland, the STOCER Capital Rehabilitation Centre in Konstantin, and established one of the first university departments of rehabilitation in Europe. His medical achievements included Weiss' spring arthroplasty, a me-thod for stabilising the spine after an injury. He also promoted myoplastic amputation and early intraoperative prosthetic support (so-called rapid prosthesis) as well as early comprehensive rehabilitation, which is widely recognized today. Prof. Weiss was a first-rate scientist and lecturer. He published more than 200 articles in Polish and international journals, a few textbooks and monographs. He delivered many lectures and presentations at domestic and international congresses and symposia. As early as 1959, he lectured at international seminars on prosthetics and rehabilitation of amputees. As an expert of the WHO Regional Bureau, he organized international training workshops on rehabilitation, with English and French as languages of instruction. He was an honorary member of the New York Physical Medicine Society, held an honorary doctorate from Rennes University and an honorary membership of the Swedish Orthopaedic Society, and received the Honorary Medal of Vishnevsky Institute in Moscow. He also was Vice-president of the "Paraplegia" International Medical Society. His unexpected death in 1961 put an end to his further organizational, professional, scientific and educational plans.

[Factors effecting frequency of occurrence of back pain syndromes]. / Czynniki wplywajace na czestosc wystepowania zespolów bólowych kregoslupa.

Low back pain syndromes are in the group of the commonest diseases observed in recent years and bear serious medical, social and economical burden. According to European data more than 70% of population suffered from back pain at least for a week in the lifetime, and 15-40% of population experiences low back pain every year. There is alarming decrease in the age of first onset described by many authors. Peak morbidity is observed in persons aged between 35 and 55 years, but a recent Japanese study brings evidence that 66.7% of middle-school children has already experienced low back pain lasting for at least 1 week, and relapse rate exceeds 60%. Increase of incidence and morbidity of low back pain is linked to lifestyle alterations including significant limitation of physical activities since young age, changes of hobby preferences, alteration of work habits favoring activities performed in improper body position lasting for hours or even years, to dynamic physical work. Pain may be presented in any phase of spinal overload syndromes. Back pain may result from nocyceptive activation in spinal, paraspinal tissues as well as irritating of nervous structures within vertebral canal, when appears as a neuropathic pain. Pain in spondylolisthesis may be related to ligamentous constrain, particularly when posterior longitudinal ligament (densely supplied with nocyceptive endings) is involved. The paper describes the commonest back pain syndromes and spinal deformities resulting from long-lasting overload with their typical presentation.

Surgery and subsequent rehabilitation for cervical spine tumours compressing neural structures.

Bone malignancies account for merely about 1.5% of all cancers, with a small percentage of these tumours developing in the cervical spine. However, the cervical spine is also the site of benign tumours and neoplasms involving not only bony tissue. Benign tumours do not metastasize but pose a threat to the spinal cord when located intrathecally. Even though such tumours do not represent malignancy, they are considered to be locally malignant. The most common cervical spine neoplasms are intradural tumours, usually extramedullary: neurofibromas, meningiomas or gliomas.Indications for surgery depend of the nature and location of the tumour and the consequences of tumour growth. Surgery is obviously necessary for intrathecal tumours compressing the spinal cord. The choice of surgical approach and manner of stabilisation depend primarily on the location of the lesion and the presence of spinal cord compression.Rehabilitation is indicated in all patients, but is particularly important, and at the same time difficult, when the growth of the tumour has resulted in neurological disturbances. The task is all the more difficult when in the presence of a massive and high spinal cord damage. Rehabilitation programmes should be designed individually for each patient and should account for the degree of paresis, stage of the underlying malignant disease, survival prognosis, disturbances in the function of other systems, apart from musculoskeletal apparatus, age of the patient, his or her commitment to treatment and other factors.The treatment of malignant neoplasms is usually associated with an unfavourable outcome. However, combination drug treatments, radiation therapy and surgery with subsequent rehabilitation will often prolong survival, ameliorate suffering and improve patients' quality of life.

[Treatment of post-traumatic instability of the cervical spine--30 years experience]. / Leczenie pourazowej niestabilnosci szyjnego odcinka kregoslupa--30 lat doswiadczen.

BACKGROUND: Assessment of the stability of the cervical spine following an injury is an important part of the diagnostic work-up. It is not always easy as the mechanism of injury does not always determine the degree of spinal stability. An actual instability is often confused with increased compensatory instability that is still within physiological limits, i. e. excessive mobility of the segment positioned above the part that has been immobilised as a result of trauma or vertebral block. Spinal injuries with instability are usually an indication for surgery. On the basis of 30 years' experience, the author presents indications for anterior approach surgery, based on the mechanism of injury and the patient's neurological status following an injury to the cervical spine. MATERIAL AND METHODS: A total of 1,225 patients have been operated on. Indications are defined for surgery using rod or plate implants and compression plates. Radiographic and neurological outcome data are presented for 1138 who had been followed up for at least 6 months. RESULTS: A good radiographic outcome was obtained in a total of 78% patients, including 84% of the recipients of rod implants and 65% of the recipients of plate implants. Neurological improvement was seen in 68% of patients with neurological symptoms, including substantial improvements in 26% of the patients. CONCLUSIONS: 1. Assessment of spinal stability is an important element of diagnostic work-up. 2. It is essential to distinguish actual instability requiring surgery from a compensatory increase in mobility of the segment lying above the immobilised segment of the spine. 3. An anterior approach procedure, apart from stabilising the spine, serves to decompress the spinal cord and offers a chance of neurological and functional improvement.

Cervico-cephalic syndrome in the course of degenerative disease of the cervical spine.

This article contains a synthesis of views concerning cervico-cephalic syndrome, which results from degenerative changes in the cervical spine. The pathophysiology of the syndrome is discussed, along with contemporary methods of diagnosis and therapy, with indications for conservative and surgical treatment.