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At least 91 records · Page 5Linked to original sources
PubMed2003

Diagnosis of spinal disease with ultrafine flexible fiberscopes in patients with chronic pain.

STUDY DESIGN: Spinal epidural and subarachnoid spaces were observed with the newly developed fine flexible fiberscopes in 55 patients with chronic pain. OBJECTIVES: To evaluate the fiberscopes as diagnostic tools for spinal canal disease. SUMMARY OF BACKGROUND DATA: Fine flexible fiberscopes make it possible to visualize the entire length of the spinal subarachnoid space without major complications, and they may be of value for the diagnosis of certain spinal canal diseases. METHODS: The epidural and subarachnoid spaces were accessed by fine flexible fiberscopes (Purely Fine [PF] types) in the initial 45 patients and by those equipped with a tip-steering function and a working channel (Medical Science [MS] types) in the later 10 patients, respectively. The procedures were based on those of continuous epidural or subarachnoid block. RESULTS: Normal and abnormal subarachnoid spaces were clearly observed. When the MS types were used, the intended sites of the spinal structures could be more easily approached. In 12 patients, new diagnoses were made (chronic arachnoiditis 9, subarachnoid cyst 2, old subdural hematoma 1) that could not be found by magnetic resonance imaging or computed tomography. Additionally, chronic arachnoiditis was found in 2 patients with spinal trauma. Pathologic changes were confirmed by fiberscopic examination in 16 patients (arachnoiditis 11, spinal trauma 2, arteriovenous malformation 2, subarachnoid cyst 1). No pathologic changes could be detected in 27 patients with spinal canal stenosis, disc herniation, reflex sympathetic dystrophy, or posttraumatic pain syndrome. There were no significant differences in incidence of new diagnoses between the PF and MS types of fiberscopes. There were no major complications. There were 2 cases of light fever in the initial 10 patients and 7 cases of headache in the initial 14 patients. Only 4 cases of headache were observed in the subsequent 41 patients, in whom 20 mL of saline was injected into the epidural space. CONCLUSION: These fine flexible fiberscopes may provide new diagnostic and interventional tools for spinal canal diseases, provided skilled techniques are applied.

Adult↗
PubMed1993

[The psychological-algological characteristics of patients with posttraumatic spinal cord and spinal diseases].

Based on the psychological testing of spinal patients the authors regard a possibility of the use of these methods in clinical practice, study the self-estimation of the health status, the intensity of chronic pain. Strong correlations are noted in the self-estimation of the life quality and choice of affective descriptors. A list of the most frequently used semantic descriptors is provided.

Adult↗
PubMed1989

[The importance of myelography with water soluble contrast medium in follow-up neuroradiologic diagnosis of spinal diseases].

We analyzed the outcome of diagnostic processes in 102 cases of unclear spinal affections. Myelography, spinal CT with and without contrast media, and, in several cases, spinal MRI were performed. Facing a higher number of false positive or false negative diagnoses after the initial CT scans we propose the classical myelography with a water-soluble contrast medium to be initial neuroradiological method for detection of spinal processes, especially in the cervical region.

Female↗
PubMed1995

[Focal epilepsy with seizures from the supplementary sensorimotor area. False interpretation as a spinal disease].

The symptomatology of focal epileptic seizures depends on the brain region involved in the epileptic discharge. We report a case in which ictal symptomatology was misinterpreted to be a spinal disease, leading to MRT, CT and X-ray of the lumbar region, which revealed normal results. The ictal symptomatology consisted of a tingling sensation in the lower back, followed by a feeling of tonic tension of the proximal left leg. Ictal EEG video recordings consistently revealed an EEG seizure pattern over the right parasagittal frontocentral region. We concluded that the patient is suffering from a focal epilepsy. The seizures most probably arise from the supplementary sensorimotor region. Carbamazepine treatment rendered the patient free of seizures.

Adult↗
PubMed1995

Neutron activation analysis of trace elements in motor neuron disease spinal cord.

Levels of 10 trace elements were analysed in autopsied lumbar spinal cords of 38 motor neuron disease patients and 22 control subjects using instrumental neutron activation analysis. Statistically significant elevations of iron, selenium and zinc, and depletions of mercury and cesium were found in the spinal cords of motor neuron disease patients compared with control subjects. No significant correlations were found between disease duration, clinical severity or lumbar motor neuron counts and iron and selenium levels, suggesting that accumulation of these elements occur early as well as late in the disease process and therefore are not a consequence of end stage pathology. Increased iron in motor neuron disease spinal cord could act to enhance formation of reactive oxygen species. Our study supports the free radical hypothesis of neuron degeneration in motor neuron disease.

Adult↗
PubMed2003

Validation of the Japanese version of the Roland-Morris Disability Questionnaire for Japanese patients with lumbar spinal diseases.

STUDY DESIGN: This study was designed to validate a translated version of the Roland-Morris Disability Questionnaire (RMDQ). OBJECTIVE: To validate the Japanese version of the RMDQ (JRMDQ) for Japanese patients with low back pain (LBP) and/or lumbar spinal diseases (LD). SUMMARY OF BACKGROUND DATA: To assess the effect of interventions, a scale that directly assesses disabilities in patients with LBP and/or LD and that can be used internationally needs to be established in Japan. MATERIALS AND METHODS: To promote the JRMDQ, the RMDQ was translated into Japanese and then back-translated. In four hospitals, 320 patients with LBP and/or LD were examined. At first, they were examined using the JRMDQ, the Japanese Orthopedic Association (JOA) score, and the visual analogue scale (VAS). The repeatability of the JRMDQ was evaluated in 55 patients by two examinations within 2 weeks. To examine the validity of the JRMDQ, the correlation between the JRMDQ and other scales was calculated in all 320 patients. RESULTS: The JRMDQ demonstrated significant repeatability (R = 0.810, P < 0.0001). The JRMDQ and other scales demonstrated significant correlations (JRMDQ-JOA, R = -0.772; JRMDQ-ADL items of JOA score, R = -0.790; JRMDQ-VAS, R = 0.447, P < 0.0001). CONCLUSIONS: The JRMDQ is a repeatable and valid questionnaire for assessing disabilities caused by LBP and/or LD. The JRMDQ is equivalent to the English RMDQ.

Activities of Daily Living↗
PubMedDate not supplied

Intraoperative spinal ultrasonography in two dogs with spinal disease.

Ultrasonography was performed during spinal surgery on two dogs that were suspected of having intramedullary lesions by myelography and magnetic resonance imaging. Ultrasonographically, the pathologic conditions of the spinal canal or cord were adequately imaged during surgery in both dogs. On the basis of ultrasonographic findings, a biopsy was obtained in Patient 1 and removal of the lesion was accomplished in Patient 2. Histopathologic diagnosis was myelomalacia in Patient 1 and spinal nephroblastoma in Patient 2. Intraoperative ultrasonography was demonstrated to be suitable for detecting intradural conditions, and, thus, is valuable for increasing the accuracy of biopsies or completeness of resections of intramedullary lesions.

Animals↗
PubMed2000

Current surgical management of metastatic spinal disease.

Despite advances in the treatment of many malignancies, a large number of cancer patients will require evaluation and possible surgical intervention for lesions that have metastasized or directly invaded the spinal column. The need for heightened awareness of and aggressive early intervention for spinal metastases is underscored by many studies that have reported a relationship between pretreatment and posttreatment neurologic function in these patients. Recommendations for operative intervention should be made following an evaluation of the patient by multiple specialties, both medical and surgical. In the last decade, advances in surgical techniques for tumor decompression and spine stabilization, neurophysiologic monitoring, and anesthetic expertise have allowed surgeons to perform more extensive procedures with improved outcomes and reduced morbidity. This article will review the factors favoring an operative recommendation in patients with metastatic spinal disease, preoperative evaluation, and available surgical options. Patients with symptomatic spinal metastases should receive early surgical consultation as part of a multidisciplinary approach to their disease process.

Humans↗
PubMed1995

Spinal disease in the aged.

Treatment of the diseased spine in the elderly is a difficult challenge for the practitioner. Spinal surgery for this population requires specialized surgical skills. Patient evaluation, nonoperative treatment, surgical indications, surgical techniques, and postoperative management involve unique considerations. The patient's functional expectations, general medical condition, and proposed benefits from surgery must be addressed before any surgical intervention. Spinal surgery for the aged requires the orthopaedic surgeon to consider this patient as more than just an older individual and demands that the entire perioperative milieu be examined and its issues resolved. The projected data on aging of the United States population make this issue increasingly important.

Aged↗