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Biomedical subjects

S W Wiesel

Publications and source records attributed to S W Wiesel.

45 records · Page 3Linked to original sources
PubMedDate not supplied

Acute low-back pain. An objective analysis of conservative therapy.

The roles of bedrest, antiinflammatory medication, and analgesic medication in the treatment of acute back strain were objectively analyzed to determine whether they have a measurable effect on the return of patients to full daily activities as well as on the relief of pain. Two hundred patients were studied prospectively. Each patient had the diagnosis of acute back strain, which was defined as nonradiating low-back pain. The results of the patient's neurologic examination, straight leg raising test, and lumbosacral spine roentgenograms had to be within normal limits for the patient to be included in the study. The results showed that bedrest, as compared with ambulation, will decrease the amount of time lost from work by 50%. Bedrest will also decrease the amount of discomfort by 60%. Analgesic medication, when combined with bedrest, will further decrease the amount of pain incurred, particularly when used in the first three days of the healing process. However, analgesic medication will not allow a more prompt return to work. Antiinflammatory medication, when added to bedrest in the treatment of lumbago, does not provide an advantage over bedrest alone.

Adolescent↗
PubMedDate not supplied

Cyclobenzaprine and naproxen versus naproxen alone in the treatment of acute low back pain and muscle spasm.

Two groups of 20 patients each, with mild to moderate acute low back pain with associated muscle spasm of ten days' duration or less, were treated with a combination of cyclobenzaprine and naproxen or naproxen alone in a randomized, 14-day open-label trial. Cyclobenzaprine was added to the naproxen regimen as an adjunct to rest and physical therapy for relief of muscle spasm associated with acute, painful, musculoskeletal conditions. The clinical characteristics of each study group, including the number of worker's compensation patients, were comparable. Combination therapy was associated with less objective muscle spasm and tenderness and greater motion of the lumbosacral spine (P less than 0.05). There were trends toward faster resolution of functional deficits and pain with combined therapy. Combination therapy was associated with more side effects, due primarily to drowsiness from the cyclobenzaprine. The results of this study demonstrated that patients with muscle spasm associated with acute low back strain benefited from the use of combination therapy consisting of a nonsteroidal anti-inflammatory agent (naproxen) and a muscle relaxant (cyclobenzaprine).

Adult↗
PubMedDate not supplied

Talonavicular coalition.

The diagnosis in 4 symptomatic cases of talonavicular coalition was made from anteroposterior roentgenograms of the feet. The pedigrees suggested a recessive mode of transmission. There were no associated anomalies of the hand.

Adolescent↗
PubMedDate not supplied

Metrizamide myelography and epidural venography. Their role in the diagnosis of lumbar disc herniation and spinal stenosis.

This study compares lumbar epidural venography with metrizamide (Amipaque) myelography as diagnostic modalities in the evaluation of lumbar disc herniation and spinal stenosis. The accuracy of epidural venography and metrizamide myelography was evaluated in 30 surgically confirmed cases of lumbar disc herniation and spinal stenosis to determine their relative diagnostic values. Sensitivities of epidural venography and metrizamide myelography were 83% and 97%, respectively, while the specificities were 88% and 100%, respectively. The conclusions of this study were: (1) The accuracy of metrizamide myelography exceeds that of epidural venography in the diagnosis of lumbar disc herniation and spinal stenosis. (2) Metrizamide myelography is indicated as the primary contrast technique in lumbar disc herniation and spinal stenosis. (3) Epidural venography is indicated as a secondary contrast technique in patients with a congenitally short or tapered dural sac.

Adult↗
PubMedDate not supplied

Cauda equina syndrome presenting as a herniated lumbar disk.

Cauda Equina Compression (CEC) is a clinical syndrome consisting of low back pain, bilateral sciatica, saddle anesthesia, bilateral lower extremity weakness, and even frank paraplegia with bowel and bladder incontinence. At the onset of CEC, the clinical picture may resemble typical intervertebral disk disease with low back pain and unilateral sciatica. The back pain is severe, overshadowing the leg pain, and should alert the physician to the periodic evaluation of the patient and evidence of a progressive neurologic deficit. Early discovery of CEC is necessary if neurologic recovery is to be expected from decompressive laminectomy.

Aged↗