[The effect of joint facet asymmetry on the pathogenesis of lower segments of the lumbar spine]. / Wplyw asymetrii wyrostków stawowych na powstawanie zmian chorobowych dolnych segmentów odcinka ledzwiowego kregoslupa.

Magnetic resonance and computed tomography scans of L4/5 and L5/S1 levels in 129 patients operated for herniated intervertebral disc were assessed to establish the relationship of facet joint asymmetry, disc prolapse and degenerative disease. Facet angle and spinal stenosis were measured. Statistical analysis revealed significant correlation between facet joint asymmetry and disc disease or degenerative stenosis within lumbar spine.

Fatal pulmonary thromboembolism after successful transsphenoidal hypophysectomy for Cushing's disease.

We have reported the case of a 30-year-old woman with Cushing's disease who died of massive pulmonary thromboembolism 5 weeks after successful transsphenoidal hypophysectomy. Glucocorticoid excess appears to cause a hypercoagulable state, and consideration of this thromboembolic propensity and its potential duration after cure is indicated in all patients with Cushing's syndrome during the perioperative period. At the present time, we recommend the routine perioperative use of intermittent pneumatic compression in all patients with Cushing's disease or Cushing's syndrome.

Pseudoclaudication. A review of etiology, diagnosis, and treatment.

The authors have presented an historical and clinical review of the pseudoclaudication syndrome. This disorder has become increasingly recognized during the past years, and it is important to keep in mind that pseudoclaudication can coexist with vascular insufficiency. Appropriate diagnosis and treatment can be rendered only when the correct diagnosis or diagnoses are made. As always, a thorough history and physical examination together with supplementary radiologic and neurophysiologic studies will lead the clinician to the correct cause of the symptoms presented and an appropriate course of treatment.

New concepts in diagnosis and treatment of back ailments in the elderly.

With the advances in knowledge of the pathophysiology of spinal disorders plus the revolutionary advent of axial tomography, the treatment of back disorders, particularly in the elderly, is becoming more efficacious. Invasive procedures such as myelography, diskography, and epidural venography are becoming outmoded as computer software is further developed, enabling even more sophisticated planal reconstructions, including three-dimensional displays. The outlook for the elderly patient with physically disabling back disorders is much brighter indeed.

Exophthalmos. The more commonly encountered neurosurgical lesions.

A recent discussion of exophthalmos prompted a review of the medical literature and revealed the absence of a report that summarized the diagnosis and management of the more important neurosurgical lesions that produce exophthalmos. A general survey of lesions producing either unilateral or bilateral exophthalmos was therefore conducted. The more common pathophysiologic entities that lend themselves to neurosurgical intervention was selected for review. The present manuscript aims to unify previous studies into an informative survey that combines isolated diagnostic and technical details into a single report.