Search PubMed⌕ Search

Biomedical subjects

W H Kirkaldy-Willis

Publications and source records attributed to W H Kirkaldy-Willis.

At least 19 recordsLinked to original sources
PubMed1993

Side posture manipulation for lumbar intervertebral disk herniation.

OBJECTIVES: The objective of this article is to review the status of side posture manipulation for lumbar intervertebral disk herniation. DATA SOURCES, STUDY SELECTION AND DATA EXTRACTION: The data presented in this article are from our Back Pain Clinic at the Royal University Hospital and the articles cited are those which we feel are important in reviewing this subject. CONCLUSIONS: The treatment of lumbar intervertebral disk herniation by side posture manipulation is both safe and effective. Further research is required to understand more fully the effects of this treatment on the intervertebral disk.

Chiropractic↗
PubMed1991

Causes and clinical management of vertebral osteomyelitis in Saskatchewan.

A retrospective review of all patients with vertebral osteomyelitis admitted to all Saskatchewan referral hospitals from 1973 to 1986 was undertaken to determine the incidence and clinical characteristics of the disease. There were 73 patients, an incidence of 5.3 cases/million per year. Erroneous initial diagnoses were common (41%). There was a significantly increased risk in patients older than 60 years. Staphylococcus aureus was the most frequent organism. Mycobacterium tuberculosis was present in 29.5% and was more common in native Indian patients. Surgery was performed in 31% of all patients, and in 50% of those with tuberculous infections. The outcome was excellent in 92% of patients. Diabetes and transurethral resection of the prostate were risk factors for vertebral osteomyelitis.

Adult↗
PubMed1989

Lumbar intervertebral disc herniation: treatment by rotational manipulation.

We describe the case of a patient with a lumbar disc herniation who underwent a course of side posture manipulation. Despite the appearance of an enormous central herniation on the CT scan, the patient improved considerable during only 2 wk of treatment. The disparity which so commonly exists between radiological and clinical findings is depicted in this case. Further, it is emphasized that manipulation has been shown to be an effective treatment for some patients with lumbar disc herniation. While complications of this form of treatment have been reported in the literature, such incidents are rare.

Adult↗
PubMed1988

A study of the effects of bipedism and upright posture on the lumbosacral spine and paravertebral muscles of the Wistar rat.

Twenty-one bipedal rats were prepared by forelimb amputation and reared with 19 control rats. All of the bipedal rats became proficient upright walkers. There was significant anterior wedging of the lower lumbar vertebral bodies in all of the bipedal rats and four had radiographic evidence of degenerative disc disease. Five bipedal rats developed lumbosacral disc herniations, and the lumbar neural canal was significantly smaller in the bipedal population. There was no difference in radionuclide uptake between the two groups. Histochemical analysis of the psoas and multifidus muscles showed a significant shift from type I to type II fibers in the psoas and from type II to type I fibers in the multifidus in the bipedal population. These results indicate that upright posture places considerable stress on the lumbosacral spine and paravertebral muscles of the rat.

Amputation, Surgical↗
PubMed1987

Recognizing specific characteristics of nonspecific low back pain.

A retrospective review of 1293 cases of low back pain treated over a 12-year period revealed that sacroiliac joint syndrome and posterior joint syndromes were the most common referred-pain syndromes, whereas herniated nucleus pulposus and lateral spinal stenosis were the most common nerve root compression lesions. Referred pain syndromes occur nearly twice as often and frequently mimic the clinical presentation of nerve root compression syndromes. Combined lesions occurred in 33.5% of cases. Lateral spinal stenosis and herniated nucleus pulposus coexisted in 17.7%. In 30% of the cases of spondylolisthesis, the radiographic findings were incidental and the source of pain was the sacroiliac joint. Distinguishing radicular from referred pain, recognition of coexisting lesions, and correlation of diagnostic imaging with the overall clinical presentation facilities formulation of a rational plan of therapy. The above-outlined approach to managing low back pain evolved over a 12-year period. Designed to establish a specific diagnosis, it should yield excellent or good results in 84% of patients.

Back Pain↗
PubMed1987

A comparison of the effectiveness of spinal manipulative therapy for low back pain patients with and without spondylolisthesis.

The effectiveness of spinal manipulative therapy for low back pain is compared between two groups of patients: a small group (25) of patients with lumbar spondylolisthesis and a larger group (260) of patients without spondylolisthesis. This data, which was collected from a previously published study on the effectiveness of manipulation for chronic low back pain, shows that the results of manipulative treatment are not significantly different in those patients with or without lumbar spondylolisthesis.

Adolescent↗
PubMed1987

Low back pain.

Explore the source record for details and available documents.

Back Pain↗
PubMed1986

Relationship between spinal biomechanics and pathological changes in the equine thoracolumbar spine.

The relationship between spinal biomechanics and pathological changes occurring in functionally normal equine thoracolumbar spines was studied in 23 horses. Ventrolateral vertebral body osteophytes occurred in 36 per cent of the spines. The majority occurred between the 10th and 17th thoracic vertebrae with the largest being found between the 11th and 13th thoracic vertebrae, the region of the thoracic spine where the greatest amount of lateral bending and axial rotation occurs. Impingement of the dorsal spinous processes was detected in 86 per cent of the spines with most lesions occurring between the 13th and 18th thoracic vertebrae. The severity of occurrence of impingement did not appear to be related to regional spinal mobility. Degeneration of intervertebral discs was observed in three of four specimens that were sectioned sagittally. It occurred in the first thoracic and the lumbosacral intervertebral discs and appeared to be related to the increased dorsoventral mobility and the increased disc thickness of these joints. The characteristic distribution of fractures of the thoracolumbar spine is discussed with respect to the biomechanics of the spine.

Animals↗
PubMed1985

Radiologic diagnosis of degenerative lumbar spinal instability.

A lumbar motion segment is considered to be unstable when it exhibits abnormal movement. This movement can be abnormal in quality (abnormal coupling patterns) or in quantity (abnormal increased motion). This instability can be symptomatic or asymptomatic, depending on the demands made on the motion segment. Pain is a signal of impending or actual tissue damage, and when present it indicates that a certain mechanical threshold has been reached or transgressed. Repeated transgressions will damage the stabilizing structures beyond physiologic repair, thus putting abnormal demands on secondary restraints. Radiographic study with dynamic views obtained in the frontal and lateral planes identify unstable states in the clinical environment.

Adult↗
PubMed1983

The pathophysiology of degenerative disease of the lumbar spine.

Degeneration starts in one joint and eventually involves all three joints of the three-joint-complex (one disc and two posterior joints) at an intervertebral level. Later, mechanical changes occur that affect the levels above and below and cause similar changes there. The result is multilevel lumbar spondylosis and stenosis. The spectrum of degenerative changes in a three-joint-complex progresses through three stages, which help to predict the outcome of different types of treatment.

Humans↗
PubMed1982

Computed tomography versus myelography in diagnosis of lumbar disc herniation.

Analysis of computed tomography (CT) of the lumbar spine and myelography in 48 of 52 consecutive patients with the clinical diagnosis of disc herniation, confirmed at surgery, showed CT to be superior to myelography in diagnosis. We suggest that CT should replace myelography in assessing most patients with possible disc herniation.

Evaluation Studies as Topic↗
PubMed1982

Lumbar spinal nerve lateral entrapment.

In past years, lumbar nerve lateral entrapment seldom has been diagnosed. A presumptive preoperative diagnosis has been made based on clinical findings and radiographs demonstrating disc resorption. The Computed Tomography scan has made it possible to diagnose the lesion with certainty and accuracy. Treatment for patients who do not respond to conservative measures is a bilateral minimal partial laminectomy. The lateral canal is enlarged by removing the medial and anterior parts of the superior articular process. Adhesion formation is prevented by placing a free fat graft posterior to the dura. Instability is diagnosed by examining stress radiographs and, when present, is treated by a one level posterolateral fusion. After operation, marked improvement was obtained in 62% of patients and slight improvement in another 21%; 17% were unimproved. Sixty-two per cent of patients reported no pain or mild pain. Sixty-six per cent resumed their previous occupation.

Adult↗
PubMed1981

Causes of failure of surgery on the lumbar spine.

An interinstitutional study on the failed back surgery syndrome (FBSS) has determined that failure to recognize or adequately treat lateral stenosis of the lumbar spine with resultant nerve irritation and/or compression comprised the primary etiology in 57% to 58% of patients. Other common causes were recurrent or persistent disk herniation and lumbosacral adhesive arachnoiditis. The diagnosis of stenosis was made either by high-resolution CT scan of the lumbar spine or by directly testing lateral canal and for animal patency at the time of surgery. It is now appreciated that the process of degenerative disk disease, particularly when enhanced by diskectomy, results in progressive loss of intervertebral disk volume and predisposes to future ipsilateral or contralateral lateral spinal stenosis. Degenerative disk disease is ultimately a bilateral process and therefore surgical exposure should be bilateral. The direct and indirect costs of FBSS to patients and to society as well as the toll in human suffering are very high. This is particularly a matter of concern when it is realized that for many FBSS patients, surgery could have been avoided in the first place by preventive care or by innovative conservative treatment. When surgery is indicated, adequate diagnostic tests and the execution of appropriate procedures based upon this information should largely prevent the failed back surgery syndrome.

Humans↗
PubMed1980

Low back pain.

Explore the source record for details and available documents.

Arthritis, Rheumatoid↗
PubMed1978

Pathology and pathogenesis of lumbar spondylosis and stenosis.

Study of autopsy specimens of the lumbar spine makes it possible to construct a spectrum of pathologic change. Progressive degenerative changes in the posterior joints lead to marked destruction and instability. Similar changes in the disc result in herniation, internal disruption, and resorption. Combined changes in posterior joint and disc sometimes produce entrapment of a spinal nerve in the lateral recess, central stenosis at one level, or both of these conditions. Changes at one level often lead, over a period of years, to multilevel spondylosis and/or stenosis. Developmental stenosis is an enhancing factor in the presence of a small herniation or moderate degenerative stenosis. Lesions such as major trauma, spondylolisthesis, those following spinal fusion, Paget's disease, and fluorosis, on occasion act directly to produce central or lateral stenosis.

Aged↗