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Biomedical subjects

G R Rechtine

Publications and source records attributed to G R Rechtine.

35 records · Page 2Linked to original sources
PubMed1987

Cervical rheumatoid arthritis: value of flexion and extension views in imaging.

The magnetic resonance (MR) imaging findings in the cervical spines of eight patients with long-standing polyarticular rheumatoid arthritis were reviewed. Three pathologic conditions were readily demonstrated: anterior atlantoaxial subluxation (n = 6), atlantoaxial impaction (n = 6), and subaxial subluxation (n = 6). An abnormal soft-tissue signal was noted in the preodontoid space in six patients; this signal was thought to represent the associated inflammatory mass. MR imaging was useful not only for depicting the bony abnormalities in the cervical spine that are associated with rheumatoid arthritis, but also can directly show the effect of the disease process on the spinal cord and brain stem.

Arthritis, Rheumatoid↗
PubMed1986

Postoperative laminectomy pain control using bupivacaine and epidural morphine.

In a prospective double blind study, 26 patients were evaluated for postoperative pain relief with use of epidural morphine. The variable in this study was the addition of paravertebral bupivacaine used in 14 patients. The addition of the bupivacaine did not have a statistically significant effect on lowering the analgesic requirement during the first 36 hours after surgery, the total dose of medication required during hospitalization, nor the time to the onset of supplemental pain medicine requirement. There were no problems with late respiratory depression. We conclude that the addition of paravertebral bupivacaine is not effective in decreasing the amount of pain medication that is required in lumbar laminectomy patients and adds very little to patients already receiving epidural narcotics.

Bupivacaine↗
PubMed1985

Primary amyloidoma of the spine. A case report and review of the literature.

Primary amyloidosis of bone is a rare disease process. When amyloid lesions do occur in bone, they are often associated with myeloma or other plasma cell dyscrasias. Because of its rarity and its protean clinical and radiographic picture adequate biopsy tissue for histopathologic studies is essential for accurate diagnosis. This case presents a 43-year-old man with nondescript back pain and an impressive radiographic lesion in his lower thoracic spine demonstrating the need for careful diagnostic evaluation and a high incidence of suspicion. When occurring primarily in a localized anatomic area, the prognosis for survival is excellent, and cure can be expected by local excision and reconstruction, as necessary.

Adult↗
PubMed1985

Quantitative assessment of the fifth lumbar spinal canal by computed tomography in symptomatic L4-L5 disc disease.

Interpedicular distance, interfacet distance, midsagittal diameter, and cross-sectional area at the upper aspect of the fifth lumbar spinal canal were measured from the computed tomographic (CT) scans of the spine performed in a period of 1 year. The patients were divided into four groups. Group I (25 patients) was the normal control group. Group II comprised 29 symptomatic patients who were thought to have an L4-L5 herniated nucleus pulposus (HNP) by CT and did not undergo surgery. Group IIIA was made up of 24 patients who underwent an L4-L5 discectomy and had favorable results, and Group IIIB (3 patients) included those who failed to improve following surgery. The symptomatic patient with an L4-L5 HNP by CT who did not undergo operative treatment had a mean canal size as measured by midsagittal diameter and cross-sectional area that was smaller (P less than 0.05) than in a normal control group. In the patients who required an L4-L5 discectomy, these same measurements were smaller (P less than 0.001) when compared with the nonoperative group. In the three failure patients, all four measurements were significantly smaller than in patients in Group IIIA with the interfacet distance and the cross-sectional area differences being the greatest (P less than 0.001). The patients who are likely to undergo operative treatment have a midsagittal diameter that is less than 1.6 cm and a cross-sectional area that is less than 2.5 cm.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1984

Surgical stabilization of thoracic and lumbar spine fractures: a retrospective study in a military population.

Twenty-two patients underwent surgical stabilization of thoracic and lumbar spine fractures. Twenty patients were operated on within 4 weeks of the injury and two patients more than 1 year following injury. Harrington rods were used in 21 and Dwyer instrumentation in one. The presenting neurological deficits were: four complete, five incomplete, and 13 intact. Clinical failure was noted in four patients, two of whom underwent posterior instrumentation more than 1 year following the initial injury. The most important contributing factor to failure was use of instrumentation in deviation from standard practice. The aim of operative treatment to maintain fracture reduction, decompress neural elements, promote fracture healing, and shorten hospitalization was achieved.

Adult↗
PubMed1984

The use of epidural morphine to decrease postoperative pain in patients undergoing lumbar laminectomy.

In a double-blind study of fifty patients that was done to test the ability of epidural morphine to decrease the discomfort after lumbar laminectomy, we found that during the first postoperative day the patient's pain was lessened appreciably but that the total dose of morphine received postoperatively was not diminished. We used a three-milligram dose of epidural morphine, and there were no problems with respiratory depression. The addition of epinephrine to the morphine solution had no beneficial effect.

Adult↗
PubMedDate not supplied

Computed tomography in the diagnosis of a herniated disk at the L5-S1 level.

Six patients with a normal myelogram were found to have evidence of a herniated nucleus pulposus (HNP) at the L5-S1 level on computed tomography (CT) scan. In all six patients, the presence of the herniated disk was confirmed at surgery. Five of the six herniations were lateral. The authors found no patients with an abnormal myelogram and a normal CT at the L5-S1 level in a technically good study. The sensitivity of the CT in diagnosing an HNP at the L5-S1 interspace is greater than with myelography if images in the exact plane of the disk can be obtained.

Adult↗