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Biomedical subjects

B Magnaes

Publications and source records attributed to B Magnaes.

At least 55 records · Page 3Linked to original sources
PubMed1987

Extensive or partial microsurgical sympathectomy of the arm by supraclavicular route for primary or secondary Raynaud symptoms.

Surgery was performed in patients with Raynaud's disease (primary Raynaud symptoms) or with Raynaud symptoms as part of the cervical rib/scalenus-anticus syndrome (secondary Raynaud symptoms). In 13 arms with primary, and six with secondary Raynaud symptoms with trophic changes, the aim was extensive sympathectomy. Good results, without Horner's syndrome, were obtained with extensive postganglionic sympathectomy. When the grey ramus T1 could not be identified, T2 ganglionectomy and extirpation of the grey rami C7 and C8 were performed with the same result. Extirpation of the grey ramus C6 was not mandatory for a good result. Extirpation of unidentified T1 rami resulted in permanent Horner's syndrome in two of four patients. Cases of secondary Raynaud symptoms without trophic changes were divided into two equal groups, each of 18 arms. Combined neurovascular decompression and partial sympathectomy were performed in one group, and neurovascular decompression only in the other. Partial sympathectomy seemed to improve the results.

Adult↗
PubMed1982

A prospective comparison of computed tomography and myelography in the diagnosis of herniated lumbar disks.

Although CT effectively demonstrates normal and herniated intervertebral disks, the value of CT in low back pain has not been adequately evaluated. We compared CT prospectively with myelography in 107 patients referred to Ulleval Hospital Department of Radiology for myelography. Fifty-two patients subsequently had spinal explorations, one patient twice during the study and two patients at two levels. Forty-six CT and 44 myelographic diagnoses agreed perfectly with the operative diagnosis at that level. In 30 disk herniations, there were 29 true-positive CT diagnosis and 28 true-positive myelographic diagnoses. False-negative diagnoses of herniated nucleus pulposus were made twice on myelography and once on CT. In 24 other spinal operations, there were eight false-positive CT and nine false-positive myelographic diagnoses of herniated nucleus pulposus. CT demonstrates lumbar disk disease as effectively as myelography.

Adolescent↗
PubMed1982

Cerebrospinal fluid hydromechanics in adult patients with benign noncommunicating hydrocephalus: one-hour test shunting and balanced cerebrospinal fluid infusion test to select patients for intracranial bypass operation.

Cerebrospinal fluid (CSF) pressure and absorption were determined in 12 patients with benign noncommunicating hydrocephalus. An extracorporeal communication of plastic tubing between the ventricular system and the lumbar subarachnoid space was established to imitate the hydromechanical condition after an intracranial bypass operation. This extracorporeal shunt, which in effect was an externalized Torkildsen shunt, served first as a test shunt for 1 hour and then as a route for the constant rate CSF infusion test. The total CSF absorptive capacity was thus determined under a condition of balanced CSF pressure between the proximal and distal compartment. Four patients, whose tests showed normal CSF pressure and absorption, were selected for intracranial bypass operation. Follow-up examination showed a normal clinical condition, reduction of the ventricular system, normal CSF pressure, and normal CSF absorption in all 4 patients. The other 8 patients, whose tests indicated impaired CSF absorption, were treated by ventriculoatrial shunting. The tests were valid in selecting patients for intracranial bypass operation.

Adolescent↗
PubMed1982

Surgical treatment of severe angular kyphosis.

Five patients 10-21 years old were treated for severe angular kyphosis, ranging from 61 to 133 degrees, by a three-stage procedure: 1. distraction in a halo-pelvic apparatus, 2. anterior decompression and/or fusion and 3. posterior fusion with Harrington compression rods. An average correction of 68% and a good cosmetic result were obtained. A solid fusion was achieved in all patients. There were no neurological complications. A 12-year-old girl gained 20 cm in height and the spinal kyphosis was reduced from 133 to 27 degrees.

Adolescent↗
PubMed1982

Clinical recording of pressure on the spinal cord and cauda equina. Part 1: the spinal block infusion test: method and clinical studies.

When an intraspinal expanding lesion causes a spinal block, a segment of the spinal cord or cauda equina will be subjected to general pressure from the surrounding tissue. This spinal block pressure, the spinal equivalent to intracranial pressure, was measured by lumbar infusion of fluid and simultaneous recording of the volume-pressure curve caudal to the block. The point of deviation from or breakthrough of the exponential volume-pressure curve indicated the spinal block pressure. Spinal block pressure of about 500 mm H2O and more could be determined by this method, and, when it was combined with Queckenstedt's test, lower pressures could be assessed as well. In the static (thoracic) part of the spine, spinal block pressure up to the level of arterial blood pressure was recorded. In the dynamic part of the spine, however, spinal block pressure could exceed arterial blood pressure due to external compressive forces during extension of the spine. There was a general tendency for more severe neurological deficits in patients with high spinal block pressure; but the duration of the pressure, additional focal pressure, and spinal cord compared with nerve root compression seemed equally important factors. The recording has implications for diagnosis, positioning of patients for myelography and surgery, selection of high-risk patients for the most appropriate surgical procedure, and detection of postoperative hematoma. There were no complications associated with the recordings.

Adolescent↗
PubMed1982

Clinical recording of pressure on the spinal cord and cauda equina. Part 2: position changes in pressure on the cauda equina in central lumbar spinal stenosis.

To define the site, degree, and dynamics of mechanical compression of the spinal nerve roots, pressure was measured in 42 patients with clinical symptoms and myelographic findings indicating central lumbar spinal stenosis. Pathological pressure on the cauda equina was found in 67% of the patients. The pressure in the region of the spinal block was high during standing and walking, and in several patients exceeded mean arterial blood pressure. The block pressure was the main mechanical factor in the central part of the spinal canal causing pain and paresis. Elevated fluid pressure caudal to the block was an additional but usually subordinate factor. In 33% of the patients, normal pressure on the cauda equina was found, and lateral compression of multiple nerve roots seemed to be the only mechanical symptom-causing factor. Clinically, these patients could not be distinguished from patients with central compression. After laminectomy with decompression of the cauda equina, the field should be inspected for lateral narrowing which, if present, should be treated.

Adult↗
PubMed1982

Clinical recording of pressure on the spinal cord and cauda equina. Part 3: pressure on the cervical spinal cord during endotracheal intubation in patients with cervical spondylosis.

Pressure on the spinal cord with the neck in the extended position for endotracheal intubation was recorded in eight patients with a narrow spinal canal due to cervical spondylosis. Pressures up to about 1400 mm H2O were recorded. Longitudinal skeletal traction with the tong placed frontally reduced the pressure on the spinal cord in all patients. When longitudinal skeletal traction was applied, the stress of the neck extension was probably in part transferred from the lower cervical spine where the canal was narrow to the upper cervical spine with the more spacious canal. Placing the tong for longitudinal skeletal traction frontally when performing endotracheal intubation is advocated in patients with cervical spondylosis and probably also in patients with injuries of the lower cervical spine.

Cauda Equina↗
PubMed1980

Rheumatoid arthritis of the lumbar spine leading to anterior vertebral subluxation and compression of the cauda equina.

A 71-year-old woman with rheumatoid arthritis suffered a spontaneous anterior subluxation of the fourth lumbar vertebra with compression of the cauda equina. The patient was operated upon with a decompressive lumbar laminectomy and a stabilizing posterior interbody fusion of L4 and L5. Histological examination of the unstable L4-L5 motor segment showed that the apophyseal and discovertebral joints had been destroyed by rheumatoid granulation tissue.

Aged↗
PubMed1980

Rheumatoid backward dislocation of the atlas with compression of the spinal cord.

A 61-year-old man suffered a rheumatoid destruction of the dens of the C-2 vertebra with subsequent backward dislocation of the atlas resulting in tetraparesis. The clinical picture was consistent with a central spinal cord syndrome with motor impairment more of the upper than of the lower extremities. Reduction of the dislocation with skull traction followed by a posterior fixation from the occiput to C-3 resulted in a marked neurological restitution.

Arthritis, Rheumatoid↗
PubMed1978

Communicating hydrocephalus in adults. Diagnostic tests and results of treatment with medium pressure shunts.

In a study of 60 patients with communicating hydrocephalus, sources of error included lumbar cerebrospinal fluid (CSF) leakage, epidural infusion, and cerebrovascular reactions during the CSF infusion test; a high frequency of failing shunts; and initially undetected tumors in the group whose hydrocephalus was idiopathic. Though no sharp distinction could be made between positive and negative diagnositc tests, each variable indicated a certain probability of benefit, ranging from high to low, from shunting. CSF opening pressure in the lateral and sitting positions, the CSF infusion test, and cisternography were helpful in selecting patients for shunting. If clinical improvement was to take place, it did so within 3 months of shunting. Only patients with an opening pressure at or within the upper half of supposedly normal CSF pressure improved from a medium-pressure shunt. Improvement occurred in all patients having pressures of 580 mm H2O or more during an infusion test at a rate of 1.5 ml per minute. Neither preoperative signs and symptoms nor a single electroencephalogram had predictive value.

Adult↗
PubMed1978

Treatment of rheumatoid pachymeningitis involving the entire thoracic region.

A 67-year-old woman developed a spinal cord compression syndrome due to rheumatoid pachymeningitis with a roentgenological block from T2 to T11. The dura was surgically split from T1 to T12 and carefully dissected away from the spinal cord and then left open without grafting. The patient imporved and 3 years after the operation the spinal subarachnoid space and the circulation of cerebrospinal fluid were normal.

Aged↗
PubMed1978

Rheumatoid arthritis contributing to lumbar spinal stenosis. Neurogenic intermittent claudication.

Two patients with rheumatoid arthritis affecting the lumbar spine showed the clinical, roentgenological, and operative characteristics of lumbar spinal stenosis, which is a neurological complication of rheumatoid arthritis that can be treated by surgery. The clinical history is a prerequisite for suspicion of the syndrome, and lumbar myelography including roentgenograms of the extended lumbar spine may verify the diagnosis.

Arthritis, Rheumatoid↗
PubMed1978

Movement of cerebrospinal fluid within the craniospinal space when sitting up and lying down.

Postural changes in the lumbar cerebrospinal fluid pressure were recorded in patients with and without a cervical obstruction of the subarachnoid space. In patients with a free communication there was a rapid caudad movement of CSF on sitting up and a craniad movement on lying down. The relation of these changes to cerebral blood volume and to symptoms are discussed.

Cerebrospinal Fluid↗
PubMed1977

Functional Queckensted's test in rheumatoid atlanto-axial luxation.

Queckenstedt's test was carried out in 15 patients with marked rheumatoid atlanto-axial luxation. The test was done when moving the neck stepwise between flexion and extension, and with the patient in both lateral and sitting positions. The test performed in the sitting position was termed the functional Queckenstedt's test. The flexed position of the neck and the sitting body position, either alone or in combination, were factors contributing to a manometric block. Six more block phenomena were recorded in the sitting compared with the lateral position. As the sensitivity of the test seemed unaffected by body position, this indicated an increased atlanto-axial luxation in the sitting position. This applied to the neutral as well as the flexed position of the neck. There was a fairly good correlation between neurological symptoms and signs and the functional Queckenstedt's test. The use of the test as an aid supplmentary to the clinical and roentgenological findings when deciding on the treatment of patients with rheumatoid atlanto-axial luxation is outlined.

Arthritis, Rheumatoid↗