[Personal observations on combined treatment of nucleus pulposus prolapse by means of surgery, early physiotherapy and rehabilitation procedures].
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Biomedical subjects
Publications and source records attributed to S Rudnicki.
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The authors report a case of arachnoid cyst of cauda equina with severe chronic coccygodynia. The value of radioculography in the diagnosis of this condition is pointed out. Resection of the cyst abolished coccygodynia completely and permanently. No case of arachnoid cyst causing coccygodynia has been found in the available literature.
The authors carried out 66 myeloscintigraphies in 66 patients suspected of having compressing lesions of the spinal cord. In 32 cases the obtained results agreed with the results of contrast myelography which was carried out in 38 patients, and in 22 cases these results were confirmed by operations. In the remaining cases contrast myelography was abandoned in view of unequivocal results of myeloscintigraphy and conservative treatment was started. On the basis of a comparative analysis the authors stated that myeloscintigraphy is safer than contrast myelography, less troublesome for the patient and eliminates the risk connected with contrast medium remaining in the subarachnoideal space. There are practically no contraindications to its use even in outpatients, and it could even be used for screening patients with suspected spinal cord compression. Myeloscintigraphy makes possible the diagnosis of spinal tumours, arachnoideal adhesions and meningocele. In cases of nucleus pulposus prolapse the method is less reliable and less useful. For determination of the character of the pathological lesion and its relation to the spinal cord, and also in cases with doubtful results of myeloscintigraphy contrast myelography should be done.
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Exercise tests to assess both physical and coronary performance were carried out in 82 male patients aged between 31 and 62 years (mean 45.6 years) who underwent PTCA for unstable coronary disease (without a history of myocardial infarction). All patients were divided into two age groups: 31-45 years (group A), and 46-62 years (group B). Exercise test was carried out in all patients after 2-4 days, 6 and 12 months following PTCA. Ischemia was diagnosed in 15.2% of patients of group A during the first test, in 6.5% of patients during the second test, and in 4.3% of patients during the third test, indicating a decrease in ischemia. Signs of ischemia were noted in 5.6% of patients of group B in the first test increasing to 11.1% of patients during the second and third exercise testing. Ischemia was found in 6 out of 82 patients (7.3%) after one year following PTCA. Physical performance increased by 28% in patients of group A (p .01) after 6 months, and by 24.4% in patients of group B (p .01). Further increase in physical performance was noted after 12 months, i.e. by 42.1% (p .01) in group A, and by 53.3% (p .01) in group B. A significantly higher increase was noted in patients of group A (p .01) than that in group B after 6 months following PTCA. Therefore, PTCA proved beneficial in both age groups. However, this effect was first noted in younger patients.
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