[Stable arthrodesis of the lumbosacral region].
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Biomedical subjects
Publications and source records attributed to R Louis.
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This experimental work, realized on a group of 25 monkeys, aims at determining the correct circulatory direction in rachis veins and the importance of the vertebral veinous circulation in the general return circulation. Radiophysiological tests defined the azygopetal direction of the vertebral circulation, the role of the intercavous shunt of this circulation with or without obstacle, and the possibility, under certain conditions, for pelvic blood to accede to cranial sinuses. Physiopathological tests (with iode 131 and BSP) contributed to prove that vertebral veinous circulation drains 5 to 10% of lower extremity, pelvic and sus-mesocolic visceral and cranial contents circulation.
105 black african subjects were studied by plastic radio-opaque medium or anatomical dissection of the vessels in the dorso-lumbar spine. Numerous topographic variation were analyzed for pre, retro and intravertebral arteries and veins before. The results of this study are profitable to a secure surgery of the spine by the forward way. The best position for ligature is determined to avoid dangerous positions near anterior vertebral foramens and to preserve medullary circulation.
The authors estimation is that malunions are poorly tolerated at the spine level. Therefore they advocate a systematic reduction of fractures at any level of the spine after a review of 100 cases. They describe the closed procedure they used in 63 cases for obtaining reduction without anesthesia, under radiologic and manometric control. Then, in 53 cases, a plaster cast was applied. In 10 other cases, closed reduction was completed by a surgical procedure, either by an anterior or a posterior approach. 15 fractures were surgically reduced and fixed, and 22 cases were treated by rehabilitation only without reduction. An original classification was set up for a precise description of the initial lesions, and the measurement of sequellae and final results.
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