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PubMed1996

Posterior cervical arthrodesis and stabilization with a lateral mass plate. Clinical and computed tomographic evaluation of lateral mass screw placement and associated complications.

STUDY DESIGN: A prospective study evaluating screw position and associated complications in 21 consecutive patients treated with a plate and screw fixation system applied to the lateral masses of the cervical spine. OBJECTIVES: To determine the clinical safety of lateral mass screws by determining their anatomic location and clinical complications in a consecutive patient series. SUMMARY OF BACKGROUND DATA: Lateral mass plating has been advocated for procedures in which wiring techniques cannot be used, especially in instances in which the posterior elements are deficient. METHODS: The first 21 consecutive patients who underwent posterior cervical arthrodesis and lateral mass plating with a single fixation system were reviewed prospectively. Computed tomography scans taken after surgery were reviewed independently by an orthopedic spinal surgeon and by a radiologist to evaluate screw tip position. Clinical and radiographic outcome was assessed at each visit after surgery. RESULTS: Ten of 164 (6.1%) lateral mass screws were malpositioned in six patients. Three symptomatic patients underwent four additional operative procedures to remove or replace the malpositioned screws. All patients had radiographic union, and no patient developed mechanical implant failure requiring removal of instrumentation. Radiographic evaluation noted that 17% of the screws were in the central axial zone of the lateral mass on computed tomography. CONCLUSIONS: Lateral mass plating was associated with no vertebral artery or spinal cord injury. There was a 1.8%-per-screw risk of radiculopathy, which corresponds with published cadaveric studies. Radicular symptoms improved with screw removal in each case. The advantages of segmental fixation achieved with lateral mass plates and screws must be weighed against the risk of radiculopathy.

Adult↗
PubMedDate not supplied

Relationship between osteochondritis dissecans of the lateral femoral condyle and lateral menisci types.

The purpose of this study was to examine the relationship between osteochondritis dissecans (OCD) of the lateral femoral condyle and lateral menisci. From 1993 to 2002, 38 knees (28 patients) were diagnosed with OCD of the lateral femoral condyle. OCD locations were graded by the Cahill and Berg classification. The types of lateral menisci were classified by Watanabe's classification. The relationship between OCD of the lateral femoral condyle and lateral menisci was examined. On the anterior-posterior view, 25 OCDs were located in zone 4 and 13 in zone 5. The types of lateral menisci were complete discoid in 19 knees, incomplete discoid in 15, and normal in 4. Ten of the 19 complete discoid menisci were damaged. Complete discoid menisci without tears were found in OCDs located in zone 4; incomplete discoid menisci were found in OCDs located in zone 5. The authors found a relationship between the type of OCD and the state of the lateral meniscus.

Adolescent↗
PubMed2005

Biomechanical comparison: stability of lateral-approach anterior lumbar interbody fusion and lateral fixation compared with anterior-approach anterior lumbar interbody fusion and posterior fixation in the lower lumbar spine.

OBJECT: The stability of lateral lumbar interbody graft-augmented fusion and supplementary lateral plate fixation in human cadavers has not been determined. The purpose of this study was to investigate the immediate biomechanical stabilities of the following: 1) femoral ring allograft (FRA)-augmented anterior lumbar interbody fusion (ALIF) after left lateral discectomy combined with additional lateral MACS HMA plate and screw fixation; and 2) ALIF combined with posterior transpedicular fixation after anterior discectomy. METHODS: Sixteen human lumbosacral spines were loaded with six modes of motion. The intervertebral motion was measured using a video-based motion-capturing system. The range of motion (ROM) and the neutral zone (NZ) in each loading mode were compared with a maximum of 7.5 Nm. The ROM values for both stand-alone ALIF approaches were similar to those of the intact spine, whereas NZ measurements were higher in most loading modes. No significant intergroup differences were found. The ROM and NZ values for lateral fixation in all modes were significantly lower than those of intact spine, except when NZ was measured in lateral bending. All ROM and NZ values for transpedicular fixation were significantly lower than those for stand-alone anterior ALIF. Transpedicular fixation conferred better stabilization than lateral fixation in flexion, extension, and lateral bending modes. CONCLUSIONS: Neither approach to stand-alone FRA-augmented ALIF provided sufficient stabilization, but supplementary instrumentation conferred significant stabilization. The MACS HMA plate and screw fixation system, although inferior to posterior transpedicular fixation, provided adequate stability compared with the intact spine and can serve as a sound alternative to supplementary spinal stabilization.

Aged↗
PubMed2001

Measurement of the lateral recess angle as a possible alternative for evaluation of the lateral recess stenosis on a CT scan.

Stenosis of the lateral recess in the lumbar spinal canal is a clinical problem, especially in terms of surgical management. Criteria for the diagnosis and surgical treatment of lateral recess stenosis (LRS) are not clearly defined. Several authors have suggested measurement of the lateral recess height (LRH) on computed tomography (CT) scans as a helpful tool for making decisions in regard of management. The present study is based on the assumption that measurement of the lateral recess angle (LRA) may be useful in the clinical management of lateral recess stenosis. The reliability and significance of the results have been analyzed. In 35 patients, the stenosis was confirmed by intraoperative measurement of the lateral recess height. Fifty-three affected lateral recesses were analyzed. Before surgery, the heights on CT scans were measured. The mean value was 3.3 mm (SD = 0.9 mm), while 41 of them were 3.6 mm or less. Furthermore, the angles on CT scans were evaluated. The mean value was 25.9 degrees (SD = 4.9 degrees), 48 of them were 30 degrees or less and only 5 of them achieved more than 30 degrees. Results reveal that the best quantitative determination of a lateral recess stenosis is a CT scan angle measurement with a critical value of 30 degrees. A CT scan height of 3.6 mm or less is also indicative of stenosis. Statistical evaluation of the data by multiple regression analysis revealed agreement between intraoperative findings and measured heights (p = 0.02), while even better results were noted for angles (p < 0.01). Interfacet distance (IF) was found to be least predictive (p = 0.04).

Adult↗
PubMed1996

[The lateral abdominal island flap--the lateral intercostal neurovascular island flap].

This work studied the lateral abdominal island flap, its clinical value, transposition range and the practicability of a modified operative method. Five lateral abdominal island flaps were used in 5 patients. Four of them were for axillary radiation ulcers after radical mastectomy. One was for a sacral defect after resection of a recurrent fibrosarcoma. All the flaps obtained satisfactory results. Clinical applications revealed that the blood supply of the lateral abdominal skin was mainly from the lateral cutaneous branches of the 9th, 10th and 11th intercostal arteries, among which there were numerous anastomoses. The lateral abdominal island flap can be pedicled with any of these lateral cutaneous branches. The long pedicle of the flap provides a wide range of trnasposition from the axilla to the sacrum. As the pedicle of the flap contains the lateral cutaneous branch of the intercostal nerve, the flap can bring sensation function to the recipient area. The modified operative method of the lateral abdominal island flap is introduced.

Adult↗
PubMed2003

Using a continuous index of laterality to determine how laterality is related to interhemispheric transfer and bimanual coordination in children.

We sought to determine whether laterality is related to interhemispheric transfer and bimanual coordination during development. Children between 3 and 8 years of age were observed. In the first part of the experiment, we devised a continuous index to order the subjects according to their laterality. The laterality index included evaluation of hand and eye preference, and the right-left performance difference. In the second part of the experiment, we used this single index to determine whether laterality is related to interhemispheric transfer and bimanual coordination. Interhemispheric transfer was assessed by means of two tactile transfer tasks and one visuo-manual transfer task. We assessed bimanual coordination using the tapping task and the bimanual crank-rotation task. Results showed that right- and left-hand writers overlap on certain measures of laterality. They confirmed the improvement of interhemispheric transfer at around age 5 years, earlier progress in bimanual coordination with mirror than with parallel movements, and the existence of a relationship between visuo-manual interhemispheric transfer and bimanual coordination. The laterality index was not related to interhemispheric transfer, but it was related to the younger subjects' performance on the bimanual crank-rotation task: the less right handed, the better the bimanual coordination. In addition, on the same bimanual task, crossed hand-eye laterality was associated with better performance.

Attention↗
PubMed2004

Dissociating the roles of right ventral lateral and dorsal lateral prefrontal cortex in generation and maintenance of hypotheses in set-shift problems.

Although patient data have traditionally implicated the left prefrontal cortex (PFC) in hypothesis generation, recent lesion data implicate right PFC in hypothesis generation tasks that involve set shifts (lateral transformations). To test the involvement of the right prefrontal cortex in a hypothesis generation task involving set shifts, we scanned 13 normal subjects with fMRI as they completed Match Problems (a classic divergent thinking task) and a baseline task. In Match Problems subjects determined the number of possible solutions for each trial. Successful solutions are indicative of set shifts. In the baseline condition subjects evaluated the accuracy of hypothetical solutions to match problems. A comparison of Match Problems versus baseline trials revealed activation in right ventral lateral PFC (BA 47) and left dorsal lateral PFC (BA 46). A further comparison of successfully versus unsuccessfully completed Match Problems revealed activation in right ventral lateral PFC (BA 47), left middle frontal gyrus (BA 9) and left frontal pole (BA 10), thus identifying the former as a critical component of the neural mechanisms of set-shift transformation. By contrast, activation in right dorsal lateral PFC (BA 46) covaried as a function of the number of solutions generated in Match Problems, possibly due to increased working memory demands to maintain multiple solutions 'on-line', conflict resolution, or progress monitoring. These results go beyond the patient data by identifying the ventral lateral (BA 47) aspect of right PFC as being a critical component of the neural systems underlying lateral transformations, and demonstrate a dissociation between right VLPFC and DLPFC in hypotheses generation and maintenance.

Adult↗
PubMed1980

Lateral asymmetry of the Hoffmann reflex: relation to cortical laterality.

Lateral asymmetry of the Hoffmann reflex (H-reflex) recovery curve was found in seven subjects with no personal or family history of neurological or psychiatric disorder. Differences between recovery curves from the right and left leg were larger than differences in the same leg on two successive test days. In a group of 27 psychiatric inpatients, lateral asymmetry of the later portion of the recovery curve was correlated with cortical laterality, as measured by selective identification of differing verbal stimuli presented simultaneously to both ears (DL) and to total laterality scores, a sum of visual half-field, DL, and motor laterality scores. Asymmetry of the recovery curve is related in part to cortical laterality, possibly through selective activation of cortical motor centres on the preferred side.

Adult↗
PubMedDate not supplied

[Identification of auditory laterality by means of a new dichotic digit test in Spanish, and body laterality and spatial orientation in children with dyslexia and in controls].

INTRODUCTION: In this study, a new dichotic digit test in Spanish (NDDTS) was applied in order to identify auditory laterality. We also evaluated body laterality and spatial location using the Subirana test. SUBJECTS AND METHODS: Both the dichotic test and the Subirana test for body laterality and spatial location were applied in a group of 40 children with dyslexia and in a control group made up of 40 children who were paired according to age and gender. The results of the three evaluations were analysed using the SPSS 10 software application, with Pearson's chi-squared test. RESULTS: It was seen that 42.5% of the children in the group of dyslexics had mixed auditory laterality, compared to 7.5% in the control group (p < or = 0.05). Body laterality was mixed in 25% of dyslexic children and in 2.5% in the control group (p < or = 0.05) and there was 72.5% spatial disorientation in the group of dyslexics, whereas only 15% (p < or = 0.05) was found in the control group. CONCLUSIONS: The NDDTS proved to be a useful tool for demonstrating that mixed auditory laterality and auditory predominance of the left ear are linked to dyslexia. The results of this test exceed those obtained for body laterality. Spatial orientation is indeed altered in children with dyslexia. The importance of this finding makes it necessary to study the central auditory processes in all cases in order to define better rehabilitation strategies in Spanish-speaking children.

Adolescent↗
PubMed1996

Efferent neurons of the lateral line system and their innervation of lateral line branches in a euteleost and an osteoglossomorph.

The efferent neurons of the lateral line system of the euteleost Aplocheilus lineatus and the osteoglossomorph Pantodon buchholzi, both surface feeding fish, were examined by neuronal tract tracing. Besides horse-radish peroxidase, fluorescent dextrans were used as tracers to allow simultaneus visualization of projections from different lateral line branches. Labeled efferent neurons were found in nuclei situated in the medulla ventral of ventricle IV. This position resembles the octa-volateralis efferent nucleus of previous studies. The number of labeled cells in the efferent nucleus is low in both species. Most neurons were found ipsilaterally to the application site, some along the midline and only very few contralaterally. The size of efferent cells differs distinctly between Aplocheilus, possessing small cell-bodies (length 16.5 microm), and Pantodon, which has very large efferent cells (length 47.0 micron). Efferent axon bundles course rostrally in both species, leaving the brain at the level of the anterior lateral line nerve. Only Aplocheilus has in addition lateral axon bundles leaving the brain at the level of the posterior lateral line nerve. After application of one fluorescent tracer to the lateral ramus and a different fluorescent tracer to the superficial ophtalmic ramus in a given animal, double-labeling of efferent cells hardly ever occurs. If the neuromasts I and IV of the dorsal skull of Pantodon are applied with one fluorescent tracer each, approximately 10% of centrally labeled cells are double-labeled. Considering the results of double-labeling, the concept of a differential innervation of lateral line branches is supported and discussed.

Animals↗
PubMed1987

Lateral excitation in the cat lateral geniculate nucleus.

Visual responses were elicited by global phase reversal stimuli in cells of the cat dorsal lateral geniculate nucleus (dLGN) after small retinal lesions had been centered on each receptive field. After acute lesions of different sizes exclusively lateral inhibition was found. When GABAergic inhibition was blocked by continuous microiontophoretic application of bicuculline lateral excitation emerged in dLGN cells partially deafferented by small and medium size acute retinal lesions, but not in those affected by large lesions. This indicates the presence of excitatory retinal inputs at the periphery of the dLGN cell dendrites which are normally suppressed by strong, long-ranging lateral inhibitory processes. After chronic deafferentation, the remaining excitatory inputs increase in effectiveness and lateral excitation is seen without blockade of inhibition. The maximal lateral spread of excitation (300 micron) in the dLGN is distinctly smaller than the extent of lateral inhibition (1000 micron).

Animals↗
PubMed2005

Effects of lateral retinacular release on the lateral stability of the patella.

The objective of this cadaveric study was to evaluate quantitatively the effects of lateral retinacular release on the lateral stability of the patella. A materials testing machine was used to displace the patella of seven cadaveric specimens 10 mm laterally while measuring the required force, with 175 N quadriceps tension. The patella was connected via a ball-bearing patellar mounting 10 mm deep to the anterior surface to allow rotations. Patellar force--displacement behaviour was tested from 0 degrees to 60 degrees knee flexion. At 0 degrees , 10 degrees and 20 degrees flexion the mean force required to displace the patella 10 mm laterally was reduced significantly due to lateral retinacular release, by 16-19%. The average force required to displace the patella was also reduced for larger flexion angles, although this was not statistically significant. These findings suggest that lateral retinacular release may not be appropriate in treatment of patellar lateral instability.

Aged↗
PubMed2006

Surgical exposure of lateral orbital lesions using a coronal scalp flap and lateral orbitozygomatic approach: clinical experience.

BACKGROUND: The lateral extraconal compartment is a typical localization of intra-orbital tumours. With the exception of anterior lesions, which can be reached by a transconjuntival route, most of these tumours are currently approached through the classic lateral orbitotomy originally described by Kronlein. We present here our experience in the management of lateral orbital lesions, using a coronal skin flap, followed by subfascial dissection of the temporalis muscle. The procedure was intended to overcome the potential drawbacks associated with the classic transtemporal approach. METHODS: The approach was used in eleven patients harbouring bone lesions of the lateral orbital wall or intra-orbital lesion of the lateral extra-ocular compartment. The postoperative results were assessed using a simple cosmetic outcome scale, which evalutated the temporalis muscle trophism and the function of the frontotemporal branch of the facial nerve. RESULTS: All lesions were satisfactorily exposed. The subfascial dissection of the temporalis muscle is a key manoeuvre which, at the same time, abolishes the risk of injury to the frontotemporal branch of the facial nerve and provides a wide exposure of the lateral orbital wall. The cosmetic outcome was excellent in 9 patients and good in 2 patients. CONCLUSIONS: The reported technique is a convenient surgical option to approach lateral intra-orbital lesions, with a minimal cosmetic impact.

Adult↗
PubMed2004

[Management of zygomatic fractures via a transconjunctival approach with lateral canthotomy while preserving the lateral ligament].

INTRODUCTION: This study reports on a modified approach to treat zygomatic fracture. For the surgical approach, a transconjunctival incision and, instead of a lateral canthotomy, a superficial incision of the skin and subcutaneous tissue was used, preserving the lateral ligament. The results are compared with those of previous techniques, especially the subciliary incision. PATIENTS: In a prospective study, 30 patients (9 females and 21 males, mean age 32.1 years) with zygomatic fractures were operated using this approach. Mean follow-up time was 6 months after removal of the plates. Fractures were caused by trauma due to fighting, bicycle falls, or sport accidents. Follow-up radiographs were used to evaluate the position of the zygoma after reduction and rigid fixation. RESULTS: Reduction and rigid fixation of the fractures were possible to perform in all cases. The access to the orbital floor and the exposure of the inferior and lateral rim were satisfactory and an additional latero-orbital cut was not necessary. The disadvantage of the complete incision of the lateral ligament with the necessity of intraoperative refixation and possible ectropium of the eyelid could be avoided. Injuries or infections of the cornea or the bulbus did not occur. Postoperative complications such as scar formation resulting in entropium or ectropium were not seen. CONCLUSION: These results show that the transconjunctival approach with lateral superficial incision preserving the lateral ligament for treatment of zygomatic fractures is satisfactory in all cases of rigid fixation of both inferior and lateral rims. Because of its esthetic and functional advantages this approach has become standard in our department.

Adult↗
PubMed1983

Experimental and immunohistochemical studies concerning the major origins of the substance P-containing fibers in the lateral lemniscus and lateral parabrachial area of the rat, including the fiber pathways.

The origins and pathways of substance P-containing fibers in the lateral lemniscus and lateral parabrachial area of the rat were investigated by means of the indirect immunofluorescence technique. Following the placement of various knife cuts or lesions, the following could be concluded: (1) The cells of origin of substance P-containing fibers in the lateral lemniscus and lateral parabrachial area are localized in the ventral reticular formation of the rhombencephalon from the level of P2.8 to P7.0 in the atlas of Palkovits and Jacobowitz; (2) The fibers from these origins pass the ventral reticular formation of the rhombencephalon to form a dense bundle; (3) the fibers turn dorsally at the mid-rhombencephalon junction to reach the lateral lemniscus and lateral parabrachial area. The present study demonstrates the linking of the functions of the parabrachial area and lateral lemniscus via substance P innervation.

Animals↗
PubMed2006

Arthroscopic lateral meniscectomy in knees with lateral compartment osteoarthritis: a case series study.

PURPOSE: The purpose of this study was to investigate the intermediate-term postoperative results of arthroscopic surgery for lateral compartment osteoarthritis (OA) of the knee in a case series study. METHODS: In a series of 30 knees in 29 patients who underwent arthroscopic surgery for lateral compartment OA, we were able to observe 25 joints in 24 patients prospectively for the entire postoperative period. The follow-up period ranged from 1 to 13 years, with a mean of 5.5 +/- 3.7 years. The procedure in all cases comprised lateral partial meniscectomy with either abrasion arthroplasty, or debridement of the articular cartilage surface or microfracture. Of 25 cases, 13 underwent abrasion arthroplasty, 10 underwent debridement of the articular cartilage surface, and 2 underwent microfracture. Results were assessed by use of the postoperative knee score, findings of arthritic changes on plain knee radiographs, and other measurements of postoperative progress. RESULTS: Further surgery was required in 2 cases (8%) because of poor postoperative progress. In the remaining 22 patients, knee scores improved from a mean of 52.4 points preoperatively to 84.6 points postoperatively and mean function scores improved from 45.4 points to 82.6 points, with these favorable results being maintained at the last follow-up. The femoral-tibial angle decreased slightly as each year passed postoperatively. Radiologic progression of OA was seen at 3 years postoperatively in 7 patients (28%), but no progression was seen in 12 (48%). A positive correlation was seen between the preoperative femoral-tibial angle and postoperative results (R = 0.81, P < .01). CONCLUSIONS: When lateral compartment OA and lateral meniscal tears are both present, the clinical outcome of lateral meniscal resection was favorable. In patients with lateral compartment OA, therefore, an arthroscopic procedure, including meniscectomy, should be considered early. LEVEL OF EVIDENCE: Level IV, therapeutic case series.

Aged↗
PubMed2005

Intubating laryngeal mask for airway management in lateral decubitus state: comparative study of right and left lateral positions.

BACKGROUND: The intubating laryngeal mask has been used for the emergency management of the airway in patients placed in the lateral decubitus position. We have conducted this prospective study to compare the feasibility of placement of an intubating laryngeal mask and blind tracheal intubation guided by the intubating laryngeal mask in patients placed in the right and the left lateral positions. METHODS: A total of 82 adults of both sexes with normal airways, scheduled for cholecystectomy, were allocated randomly to be placed in either the right (n=41) or left (n=41) lateral position for the insertion of an intubating laryngeal mask and blind tracheal intubation guided by the intubating laryngeal mask under balanced general anaesthesia. A sequence of standard manoeuvres was performed after each failed attempt at intubating laryngeal mask placement and intubation. RESULTS: The intubating laryngeal mask was placed in all patients at the first attempt. Ventilation of the lungs through the intubating laryngeal mask was possible in 40 patients (97.5%) from each group after the first attempt at insertion (P=1). Following adjustments, adequate ventilation could be achieved in all patients. The first attempt success rates of blind tracheal intubation were 85.3% (35/41) and 87.8% (36/41) in the right and left lateral groups, respectively (P=1). The remaining patients from both groups (except for one patient in the left lateral group who had a failed intubation) were intubated at the second attempt. CONCLUSION: Insertion of the intubating laryngeal mask and blind tracheal intubation through it in the lateral position is feasible in patients with normal airways. These procedures have a high and comparable success rate when patients are placed in the right and left lateral positions.

Adult↗
PubMed1990

Physiology of lateral-line mechanoreceptors in a teleost with highly branched, multiple lateral lines.

The physiological aspects of the lateral line of Xiphister atropurpureus--a teleost with multiple, highly branched lateral-line canals on each body side--were investigated. In terms of sensitivity and frequency response, the lateral line of Xiphister is similar to simple, unbranched lateral-line canals. For both the dorsal and the medial trunk canal the lowest displacement threshold is in the frequency range of 100-150 Hz. Within this range, a peak-to-peak displacement of 0.2-1.0 microns is sufficient to evoke a neural response. For the stimuli applied, both the dorsal and the medial lateral-line canals had well-defined, but largely overlapping, receptive fields. A comparison of the experimental results with theoretical calculations showed that the trunk lateral line of Xiphister responds in proportion to the sum of the radial and angular water displacement components caused by a vibrating sphere. Our calculations further predict that multiple lateral lines cause a substantial increase in receptive-field size if nearby objects create water displacements that are barely above threshold and/or if a stimulus is masked by background noise.

Animals↗