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At least 541 records · Page 30Linked to original sources
PubMed2006

Contrast-enhanced MR imaging of the spine: when, why and how? How to optimize contrast protocols in MR imaging of the spine.

The optimal protocols and the role of contrast agents in spinal MR imaging are controversial. Although the diagnosis of many common spinal diseases can be reliably achieved by means of unenhanced images, contrast use is often necessary to improve lesion detection and differential diagnosis. The heterogeneity of the different spinal compartments and the wide variety of spinal pathology require tailored imaging strategies. Thus, the rules to achieve optimization of contrast protocols for MR imaging of the spine are frequently very different to those for brain imaging, and depend on the location and site of origin of the lesions in a specific spinal compartment, on the findings of unenhanced imaging, and on the concomitant use of fat-suppression techniques. Furthermore, in most cases, the small size of the examined structures requires a meticulous technique, and the administration of a contrast agent with high relaxivity, such as MultiHance, is advisable to enable the detection of tiny areas of contrast enhancement. The applications and clinical utility of post-contrast MR imaging are discussed with regard to different spinal diseases.

Contrast Media↗
PubMed1991

A study and analysis of spinal canal diseases in the Black Lion Hospital by myelography.

Sixty seven lumbar and thoracic myelographic examinations were performed during the period February 1987 to September 1988. Fourteen patients (21%) had normal myelography while 53 (79%) patients had pathological findings. Spinal canal tumours accounted for the majority of complete CSF blocks (76.7%) Seventy-five per cent of the intradural tumours showed no abnormality on plain films of the vertebral column, whereas 75% of the extradural tumours had pathological findings. Dorsal (central) disc herniation was more frequent (70%) than lateral herniation with almost equal distribution at L5-S1 and L4-L5 disc spaces. Central disc herniation was more common at L4-L5 (71%). The measurement of the interpedicular distance on plain radiograph was not found to be diagnostic in our single case of spinal stenosis.

Adolescent↗
PubMed1998

Intravesical resiniferatoxin for the treatment of detrusor hyperreflexia refractory to capsaicin in patients with chronic spinal cord diseases.

OBJECTIVE: Resiniferatoxin (RTX), a substance isolated from some species of Euphorbia, a cactus-like plant, shows pharmacological effects similar to those of capsaicin. We have studied the possibility of treating detrusor hyperreflexia refractory to intravesical capsaicin in patients with chronic spinal cord injuries, thereby providing insight into the mechanism of action of RTX on sensory neurons and its possible future pharmacological and clinical use. MATERIALS AND METHODS: RTX saline solution (30 ml at a concentration of 10(-5) M) was instilled into the bladder of 7 patients with detrusor hyperreflexia, refractory to intravesical capsaicin therapy, and left in place for 30 min. Effects on bladder function were monitored during the treatment and at follow-up (15 days and 4 weeks later). RESULTS: Fifteen days after RTX, the mean cystomanometric capacity increased significantly from 190 ml +/- 20 ml to 407.14 ml +/- 121.06 (p < 0.01), and it remained high four weeks later (421.66 +/- 74.40 p < 0.01). After 15 days, four patients had a pharmacologically induced detrusor areflexia. They emptied their bladders by clean intermittent catheterization. After four weeks, only two patients still had a pharmacologically induced detrusor areflexia. Clinically, three patients remained dry, and the other three reported a significant improvement in their incontinence and symptoms (frequency, urgency and nocturia). CONCLUSIONS: By interfering with sensory unmyelinated fibers, intravesical RTX seems to be a promising treatment option for selected cases of detrusor hyperreflexia. The ideal dosage and treatment interval have not yet been established, and further studies are necessary to confirm our preliminary results.

Administration, Intravesical↗
PubMed1996

Calcification of intervertebral discs in the dachshund: a radiographic study of 115 dogs at 1 and 5 years of age.

The vertebral columns of 115 dachshunds were x-rayed at 1 and 5 years of age. This sample represented 5.7% of all dachshunds registered with the Norwegian Kennel Club in the period 1986-1988. All dogs were clinically normal at the commencement of the study. At 1 year of age calcified intervertebral discs were identified in 34 (29.6%) of the dogs and the number of calcified discs in each individual varied from 1 to 7 with a mean of 2.7. At 5 years of age calcified discs were identified in 66 (57.4%) of the dogs and the number of calcified discs in each individual varied from 1 to 11 with a mean of 3.2. Of all dogs in which calcified discs were identified at 1 year of age, 33 (97.1%) were found to have calcified discs also at 5 years of age. Of 92 calcified discs identified in the dogs at 1 year of age, 29 (31.5%) were not calcified 4 years later. Of 211 calcified discs identified in the dogs at 5 years of age, 148 (70.1%) were not calcified 4 years before. From 1 to 5 years of age, signs of spinal disease were registered in 12 (35.3%) of the dogs in which calcified discs were identified at 1 year of age, and in 7 (8.6%) of the dogs in which calcified discs were not identified at 1 year of age. Of all dogs in which one or more calcified discs had disappeared during the study-period, signs of spinal disease were registered in 9 (75.0%).

Aging↗
PubMed2000

Self-reported sleep quality and quality of life for individuals with chronic pain conditions.

OBJECTIVE: To determine the sleep quality and quality of life for individuals with degenerative spinal disease or failed back surgery syndrome. DESIGN: Cross-sectional survey design utilizing standardized instruments. Data were analyzed with use of hierarchical stepwise multiple regression analyses. PATIENTS: One hundred sixty-seven individuals with degenerative spinal disease or postlaminectomy syndrome who presented to a tertiary care outpatient patient pain center. OUTCOME MEASURES: The Center for Epidemiological Studies Depression Index measured depressive symptomatology. A modified Pittsburgh Sleep Quality Index (PSQI) measured sleep quality. The arithmetic average of least and usual VAS ratings of pain measured everyday pain. A visual analog scale rating of highest pain during the past 2 weeks measured highest pain. The Epworth Sleepiness Scale measured daytime sleepiness. The Medical Outcome Study-Short Form-Health Survey (SF-36) measured the mental health and general health components of quality of life. RESULTS: Higher overall sleep quality and lower sleep latency primarily were related to higher ratings of physical functioning and shorter duration of pain. Ratings of the highest pain, but not everyday pain, were independent predictors of overall sleep quality and sleep latency. Daytime sleepiness was associated with younger age and depressed mood. Pain was not associated independently with daytime sleepiness. The quality of life related to mental functioning was associated positively with depressed mood and with the interaction of pain and depressed mood. None of the variables in the model (i.e., pain intensity, sleep quality, depression, and demographic variables) predicted quality of life related to overall general health. CONCLUSIONS: These data suggest that physical functioning, duration of pain, and age may be more important than pain intensity and depressed mood in contributing to decreased overall sleep quality and sleep latency. The contribution of physical functioning was particularly strong and should be included in subsequent studies of sleep, pain, and mood. The SF-36 should be compared to pain-specific quality-of-life measures to further evaluate the usefulness of this instrument with outpatients with chronic nonmalignant pain conditions.

Adult↗
PubMed1992

Management of bowel dysfunction in children with spinal cord disease or injury by means of the enema continence catheter.

Because bowel dysfunction in children with spinal cord impairment is a common and disabling problem that does not have adequate treatment, we evaluated the enema continence catheter developed in Toronto, Canada. Thirty-one children and their families were taught to administer a 20 ml/kg saline enema through this device. The children's bowel functions were evaluated 18 and 20 months after the start of the program. Six of the children dropped out of the study in the first 2 weeks and nine dropped out after between 18 and 30 months. For those remaining in the study, the proportion of continent stools rose from 28% to 94% (p less than 0.01); constipated stools dropped from 55% to 15% (p less than 0.01). Satisfaction with the bowel program increased, and five children were able to switch from diapers to lined underwear. No adverse effects were reported, and the amount of time required for toileting did not increase. Although compliance with the regimen was difficult for some families and its use carries potential risks, we believe that it can provide significant improvement in the bowel care of selected persons with spinal cord impairment.

Adolescent↗