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Biomedical subjects

Y Floman

Publications and source records attributed to Y Floman.

At least 55 records · Page 3Linked to original sources
PubMed1989

Dural penetration by interspinous process segmental spine instrumentation: case report.

A case of pseudo-meningocele complicating posterior spine fusion with interspinous process segmental spinal instrumentation is presented. The L rod rotated postoperatively 90 degrees and penetrated the dura. The presenting symptoms were pain accompanied by fixed lumbar and hip flexion contractures that improved dramatically after removal of the penetrating part. The unusual course as well as the treatment and recommendation for prevention are discussed.

Adolescent↗
PubMed1989

Isthmic spondylolisthesis in pycnodysostosis.

Pycnodysostosis is an inborn skeletal syndrome manifested by short stature with a concomitant spinal deformity and by dense sclerotic fragile bones. We report a 35-year-old woman with pycnodysostosis and isthmic spondylolisthesis. Pycnodysostosis should be added to the differential diagnosis of spondylolisthesis.

Adult↗
PubMed1989

Functional, biochemical, and structural anomalies in platelets of patients with idiopathic scoliosis.

Idiopathic scoliosis (IS) is the most common type of lateral curvature of the spine, the etiology of which is unknown. Among the various pathological changes that have been reported in IS are platelet anomalies. Since the platelets are not involved mechanically in the spinal deformity, platelet disorders may reflect a basic cellular pathology and not a secondary change attributed to the spinal curvature. In the present review, a summary of the platelet anomalies in idiopathic scoliosis is presented. The accumulated data indicate the existence of profound functional anomalies in platelets of patients with IS. An attempt is made to clarify the different anomalies and to try to link them together.

Blood Platelets↗
PubMed1987

Disseminated intravascular coagulopathy in patients with cancer undergoing operation for pathological fractures of the hip.

Disseminated intravascular coagulopathy is a serious complication of numerous pathological conditions, particularly metastatic cancer. It is rarely encountered in orthopaedic surgery. Prompt recognition and treatment is required to prevent death. We describe two patients with pathological fractures of the proximal femur due to metastatic disease who died from disseminated intravascular coagulation after operation. A high index of suspicion, careful monitoring of the clotting mechanism and prompt treatment are required.

Aged↗
PubMed1987

Cord compression as the presenting symptom of extradural malignant lymphoma.

Six patients with spinal cord compression as the presenting symptom of malignant lymphoma are described. These patients suffered from back pain for several months and were diagnosed after sudden paraparesis appeared. Five patients were treated by operative decompression followed by local irradiation, and all regained their motor function. A sixth patient presented with a more insidious paraparesis. A bone marrow aspiration established the diagnosis of malignant lymphoma, and this patient recovered with radiation and steroids alone. Thus, we recommend considering malignant lymphoma as a possible cause of acute cord compression, attempting to establish the diagnosis on an emergency basis within several hours, and attempting to achieve decompression with local radiotherapy and intravenous dexamethasone.

Adult↗
PubMed1987

Low-back pain in pregnancy.

Two hundred women were interviewed within 24-36 hours after giving birth. The patients were not examined. It was found that 56% of the patients suffered from low-back pain during pregnancy. The percentage of Caucasians was statistically higher in the back pain group. The percentage of Hispanics was statistically higher in the no pain group. Among the variables that were compared in both groups were the age, the weight gained by the mothers during pregnancy, the baby's weight, the number of previous pregnancies, number of prior children. None of the variables reached a statistically significant level. The pain group complained of pain the low-back area, which radiated in 45.5% of cases to the lower extremities. In about one-third of the patients the pain increased as the day wore on, whereas in another one-third the pain increased during the night and disturbed sleep. Standing, sitting, forward bending, lifting, and walking tended to increase the pain. Most of the patients started suffering from back pain between the fifth and seventh months of pregnancy. Several theories to explain the occurrence of backache during pregnancy are discussed.

Back Pain↗
PubMed1987

Spondylolysis in the upper lumbar spine. A study of 32 patients.

Reports of spondylolysis in vertebrae other than those of the lower lumbar spine are rare. We report 32 patients with upper lumbar spondylolysis who have been studied clinically, radiologically and scintigraphically. Twenty patients had bilateral lesions, and seven of those with unilateral lesions had structural changes or anomalies in the opposite posterior arch. Positive scans were found to be associated with a short clinical history, and indicated stress-related lesions. Our findings suggest that mechanical factors may play a role in the aetiology of spondylolysis in the upper lumbar spine similar to that which they play in the lower lumbar spine, and that local structural anomalies may contribute to abnormal loading of these vertebrae.

Adolescent↗
PubMed1987

NSAID induced avascular necrosis and arthropathy of femoral head.

The authors present the case of an 81-year-old woman with pain in her left hip. X-ray showed moderate osteoarthritic changes. The patient was prescribed diclofenal sodium (Voltaren), a nonsteroidal anti-inflammatory drug (NSAID). The patient continued use of the drug and returned 18 months later complaining of severe hip pain and difficulty in walking. X-ray, at that time, showed necrosis of the femoral head with subluxation and formation of a pseudoacetabulum. Total hip replacement was performed and the patient resumed normal daily activity. The authors point out that avascular necrosis of the femoral head, a known complication of steroid therapy, can also be caused by NSAID therapy and urge physicians to be aware of this complication.

Aged↗
PubMed1986

Lipoxygenase inhibitor and colchicine as anti-arthritic agents in the rat.

The non-steroidal anti-inflammatory agents do not have identical activities on the various pathways of arachidonic acid metabolism. The purpose of this study is to examine and compare the activities of colchicine, an anti-arthritic agent, indomethacin, a known prostaglandin synthesis inhibitor and nordihydroguaiaretic acid (NDGA), a lipoxygenase inhibitor, in an experimental model of arthritis. Acute arthritis of the knee was induced in rats by injection of lipopolysaccharide (LPS) into the joints. Arthritis was characterized by an increase in joint diameter (18%), increased synovial weight (34%) and an increase in synovial prostaglandin E (PGE) production (56%). While administration of all of the agents examined abolished LPS-induced joint diameter and synovial weight increase, only indomethacin reduced increased PGE content. NDGA and colchicine had no inhibitory effect on LPS-induced PGE production, and moreover they actually stimulated PGE production when compared to control values. It is concluded that: Among the mediators of the inflammatory process are factors sensitive to colchicine and NDGA which are not PGs. Lipoxygenase products of arachidonic acid including leukotrienes may have an important role in inflammation. Leukotrienes and prostaglandins may act in concert in mediating the inflammatory process.

Animals↗
PubMed1986

Acute increase in lateral bending of the canine lumbar disc following chymopapain injection.

Twenty-four lumbar discs in six adult beagle dogs were injected with either 0.1 ml CP (ChymodiactinR) (200 U) (12 discs) or 0.1 ml saline (12 discs) under direct vision at laparotomy. All animals were killed 1 hour later; the lumbar spine was immediately excised en bloc and frozen until biomechanical testing. After overnight thawing, test specimens were prepared and consisted of a disc and half a vertebral body on each side. The posterior elements were discarded. Each motion segment was mounted on a testing plate, with bone cement used for fixation. Lateral bending of the motion segment was tested as an analog to the motion of a disc during correction of a scoliotic spine with a distraction force. Lateral bending forces of 2 kg and 4 kg were applied for 30 minutes each. Lateral bending, creep, and residual deformity (in degrees) were recorded. CP injected disc showed an acute increase in lateral bending of 28% and 26%, respectively (2-kg and 4-kg loads) (P less than 0.001). In addition, CP injected discs showed a 25% increase in their residual angular deformity compared with the control discs (P less than 0.001). No significant changes were noted in creep values between CP and saline injected discs. This study demonstrates a significant acute increase of 28% and 26% in lateral bending of the canine disc following enzyme injection.

Animals↗
PubMed1986

The simultaneous application of an interspinous compressive wire and Harrington distraction rods in the treatment of fracture-dislocation of the thoracic and lumbar spine.

During open reduction of thoracolumbar fracture-dislocation, the normal constraints to distraction and lengthening may be ruptured and allow instrumentation to exert deleterious traction of the spinal cord. An interspinous wire across the unstable segment together with a Harrington rod may be used to prevent potential overdistribution of the spinal cord. Thirty-six patients with fracture-dislocation of the thoracolumbar spine were treated by open reduction with Harrington rods and interspinous wiring. Of 15 patients with a partial cord lesion, four made complete recovery, and nine of the remaining 11 became ambulators. Six patients with a complete paraplegia did not improve; 15 patients remained neurologically intact following the procedure. The compressive wire and Harrington rods act in concert and enable correction of kyphosis and restoration of vertebral and discal height while protecting the cord against traction. The technique is safe and does not add to operative time.

Adolescent↗
PubMed1985

Spongious and cortical osteoblastoma of the axial skeleton.

Eleven cases of osteoblastoma (spongious osteoblastoma) and four cases of osteoid osteoma (cortical osteoblastoma) involving the spine, diagnosed at Hadassah Hospital between 1970 and 1983 were analyzed. The age range was 7 to 34 years and the average clinical follow up was 63 months. The cervical spine was involved in four patients, thoracic in four, lumbar in six and the sacrum in one patient. Back or neck pain associated with stiffness was present in all cases and was often accompanied by scoliosis or torticollis. All the patients with osteoid osteoma were symptom relieved by surgery without recurrence. Seven of the patients with benign osteoblastoma presented with neurological signs or symptoms and three of these had recurrence following primary surgery. Although cortical and spongious osteoblastoma are considered as members of the same family of benign tumors of osteoblastic derivation, spongious osteoblastoma does not seem to be limited in growth potential as is cortical osteoblastoma.

Adolescent↗
PubMed1985

Surgical treatment of lumbar spinal stenosis in the elderly.

Unrelenting sciatica or intermittent neurogenic claudication in the elderly may be caused by degenerative lumbar spinal stenosis. This rather common condition is produced by advanced multilevel disc degeneration leading to facet hypertrophy, infolding of ligamentum flavum, descent of the pedicles, and occasional disc herniation. The symptoms of lumbar spinal stenosis usually do not improve with time. Despite the advanced age of some patients, surgical decompression may offer significant relief. Of 19 patients who underwent lumbar decompressive laminectomy, 18 showed sufficient improvement to return to normal daily activities.

Aged↗
PubMed1985

Aggressive osteoblastoma. A case report and review of the literature.

A recurrent osteoblastoma involving the acetabulum in a 27-year-old woman was found to be locally aggressive and histologically appeared to become more anaplastic with each recurrence. However, there was no evidence of distant metastases. Similar cases have been reported under such names as pseudomalignant or malignant osteoblastoma. In view of the prolonged clinical course without evidence of distal metastases, the term "aggressive osteoblastoma" seems to be more appropriate. The treatment of choice for such tumors should be further en bloc resection, avoiding the morbidity and possible mortality of the chemotherapy demanded by true malignant tumor of bone, as well as unnecessary ablative surgery.

Acetabulum↗
PubMed1984

Thoracic disc disease. Clinical manifestations and surgical treatment.

Thoracic disc herniation in an uncommon spinal entity. The authors discuss three variations in the presentation of the disease and point out the importance of being able to recognize both the thoracic prolapsed disc and the symptomatic degenerated nonherniated disc. The seven cases that are reported demonstrate the unique presentations of this disease and the techniques for treatment. Utilization of the anterior transthoracic approach for the excision of the herniated disc is emphasized.

Female↗