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Biomedical subjects

L Leibrock

Publications and source records attributed to L Leibrock.

14 recordsLinked to original sources
PubMed1998

The long-term clinical outcome of patients undergoing anterior cervical discectomy with and without intervertebral bone graft placement.

OBJECTIVE: This retrospective study provides data on the long-term clinical outcomes of patients with either anterior cervical discectomy alone (ACD) or anterior cervical discectomy with intervertebral bone graft placement (ACDF). METHODS: A questionnaire was mailed to 525 patients who had undergone ACD (290 patients) or ACDF (235 patients) at least 2 years previously. All procedures were performed by University of Nebraska Medical Center faculty in the Section of Neurosurgery. The follow-up period averaged 8.1 years, with a range of 2 to 14 years. RESULTS: Two hundred sixty-two (49.9%) patients responded to the questionnaire. There was no demographic difference between respondents and nonrespondents (P > 0.05). Respondents who underwent ACDF reported fewer problems with pain than did those who underwent ACD (P < 0.05). A higher percentage of respondents with ACDF reported that they had normal function than did those who underwent ACD (P < 0.05). When limited to respondents who underwent first-time, single-level operations (191 patients), similar results were obtained for the pain parameter (P < 0.05) but not for the level of function (P = 0.25). Patients with longer follow-up periods had fewer problems with pain and better levels of function (P < 0.05). CONCLUSION: Patients who underwent ACD or ACDF did well and benefited from their operations. Those who underwent ACDF did better than those who underwent ACD. Length of follow-up was also an important predictor of current levels of function and pain.

Adult↗
PubMed1996

Vertebrobasilar thrombosis associated with nonpenetrating cervical spine trauma.

Vertebral artery injuries associated with blunt trauma to the cervical spine are rare. Five cases of vertebrobasilar complications after blunt trauma to the cervical spine are reported. Four were involved in motor vehicle accidents, and one suffered a diving injury. All of these patients had documented cervical spine fractures. For two patients, the diagnosis of vertebral artery thrombosis was made on the basis of magnetic resonance angiography (MRA), and for the remaining three, cervical four-vessel arteriograms (CFVAs), were used. All the patients had occlusion of flow in either the vertebral artery or in the vertebrobasilar circulation. The patients presented with acute, non-specific changes in neurological status. Two patients had infarctions in the vertebrobasilar tertiary, one had an infarction in the middle cerebral artery territory, and two did not show evidence of cerebral infarction. Three of the patients were treated with anticoagulants. Of these, two showed a stabilization of their neurological status, and one died. The four surviving patients improved with early physical and occupational therapy. Although CFVA remains the "gold standard" for diagnosing these injuries, newer modalities, such as MRA, may be useful adjuncts. Early stabilization of the cervical spine injury and anticoagulation are beneficial.

Accidents, Traffic↗
PubMed1992

The value of intraoperative scans during CT-guided stereotactic procedures.

The accuracy stereotactic procedures performed during the pre-computed tomography (CT) era was confirmed by intraoperative X-ray pictures. With the availability of CT it is now possible to confirm the position of the probe-tip on an image of the target. For biopsy of small lesions in critical areas of the brain, permanent placement of radioactive seeds, or thalamotomy, it would be desirable to have confirmation of the site of the probe-tip prior to performing the main step of the procedure. Intraoperative CT was performed in 216 stereotactic procedures carried out on the scanner table including biopsies, aspiration of cysts, brachytherapy, aspiration of abscesses, thalamotomy, and evacuation of intracerebral hematoma. In 6 cases, inaccuracies were detected, which it was possible to correct so as to place the probe where desired.

Adolescent↗
PubMed1990

Therapy of giant intracranial aneurysms in the elderly.

A series of 13 elderly patients (eight female, five male) with giant intracranial aneurysms is presented. The mean age was 67.8 years, with a range of 57-81 years. The paper presents the significant medical problems associated with operating on elderly individuals. Surgical intervention was attempted in all cases. Following surgical treatment, eight patients (62%) are alive and functional. Three patients (23%) are alive but partially disabled. Two patients (15%) died during the perioperative period. This compares favorably with other series which include younger patients indicating surgery for giant intracranial aneurysms can be carried out in elderly patients with an acceptable morbidity and mortality.

Aged↗
PubMed1982

Brachial plexopathy in patients with breast cancer: unusual electromyographic findings in two patients.

2 patients with breast cancer developed progressive brachial plexopathy. The unusual electrographic finding in both patients was conduction block (neuropraxia) along the medial cord of the brachial plexus. The plexus was explored in 1 patient. Constrictive connective tissue or another source of nerve entrapment was not identified. The exact cause of the conduction block remains unclear; its presence neither indicates a good prognosis nor an indication for surgical exploration.

Aged↗
PubMed1979

Long-term analysis of cerebrospinal fluid shunt infections. A 25-year experience.

The authors have retrospectively analyzed 840 cerebrospinal fluid shunting procedures over a 25-year period to determine the relationships between infection rates and several possible influences on infection. Two-thirds of all shunt infections occurred within 1 month of surgery. The very young and very old had higher infection rates. Infections became less prevalent over the period of the study, and mortality from infection decreased from 35% to 6%. Successive shunts (revisions) were found to have progressively higher infection rates. Ventriculoatrial and ventriculoperitoneal silicone plastic shunts had similar infection rates (11.4% and 12.0%). The uncontrolled use of prophylactic antibiotics had no effect on shunt infections. Staphylococcus epidermidis became gradually more prevalent over the period of the study, and eventually caused one-half of all infections. Where infection occurred in the presence of prophylaxis, the infectious organism was usually sensitive to the antibiotic being used. The surgeon was found to be the largest single factor in the incidence of shunt infections. A 25-fold variance in infection rates among surgeons could be related to individual experience and technique.

Adolescent↗
PubMed1976

Simulated acute appendicitis secondary to ventriculoperitoneal shunt.

A case of simulated acute appendicitis caused by a ventriculoperitoneal shunt is described. This case presented as a perplexing clinical problem. When the diagnosis was established by laparotomy, it was apparent that another complication should be added to the list of abdominal complications which occurred secondary to insertion of a ventriculoperitoneal shunt.

Adult↗
PubMed1976

Cerebral tuberculoma localized by EMI scan.

A case of isolated supratentorial tuberculoma is described. The patient had a left facial palsy, left hemiplegia, and left proprioceptive and stereognostic deficits with negative studies until the lesion was delineated with computerized axial tomography (EMI scan). The characteristics EMI scan is helpful in delineating the nature and precise location of the lesion prior to surgery.

Adult↗
PubMed1975

Simulated acute appendicitis secondary to ventriculoperitoneal shunt.

A case of simulated acute appendicitis caused by a ventriculoperitoneal shunt is described. This case presented as a perplexing clinical problem. When the diagnosis was established by laparotomy, it was apparent that another complication should be added to the list of abdominal complications which occurred secondary to insertion of a ventriculoperitoneal shunt.

Acute Disease↗
PubMedDate not supplied

Peripheral signal void ring in giant vertebral aneurysm: MR and pathology findings.

Thin, signal void rims have been noted to surround intracerebral hemorrhages and ruptured intracranial aneurysms on magnetic resonance imaging. Proposed mechanisms include hemosiderin deposition in macrophages and high blood flow. The authors describe an example of a thick, signal void ring in a peripheral luminal thrombus of a giant vertebral aneurysm.

Aged↗