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At least 145 records · Page 8Linked to original sources
PubMed1994

[Diagnostic value of spinal puncture-biopsy in non-infectious spinal diseases. Apropos of 41 cases].

To evaluate the diagnostic value of percutaneous vertebral biopsy in noninfectious diseases of the spine, we retrospectively studied 41 cases seen between 1985 and 1992. The level of the lesion was lumbar in 29 cases, thoracic in 11, and cervical in one. There were 19 crush fractures, 11 lytic lesions, six sclerotic lesions, and three mixed lesions. The biopsy was done because of an abnormal magnetic resonance imaging signal in one patient and because of epiduritis in another. The thoracic and lumbar biopsies were done under x-ray guidance using the technique developed by Laredo and Bard. Computed tomography guidance was used for the cervical biopsy. There were no adverse events. The final histological diagnosis was metastatic disease in 17 cases (41.5%), myeloma or plasmacytoma in six cases (14.7%), primary vertebral neoplasia in two cases (4.8%), lymphoma in one case (2.4%), osteoporosis in nine cases (22%), Paget's disease in three cases (7.4%), amyloidosis in one case (2.4%), aseptic osteitis in one case (2.4%), and vertebral necrosis in one case (2.4%). A second biopsy procedure was done in three patients (surgically in two cases and percutaneously in one) because of discrepancies between histological findings and other data. The final diagnosis was metastatic disease in all three patients. Overall, the diagnostic yield of percutaneous vertebral biopsy was 92.6% and varied little with initial roentgenographic or computed tomographic findings. However, yield was only 56% for the diagnosis of tumorous lesions, with variations according to roentgenographic and computed tomographic changes, 90.1% for osteolytic lesions, 66.6% for mixed lesions, 47.4% for crush fractures, and 16.6% for sclerotic lesions.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1988

[Spin-echo sequences and rapid image sequences in a comparison of spinal diseases].

Rapid image sequences of the spine were compared with proton and T2-weighted spin-echo sequences in 30 patients concerning their diagnostic value and image contrast. The rapid series was carried out with an angle of rotation of 30%, TR of 21 and TE of 12 msec., the spin-echo sequences with a TR/TE of 2,000/20/80 msec. The quality and contrast of the rapid series was markedly inferior to the spin-echo sequences; this was particularly marked for demonstrating disc and bone degeneration. At present, the routine use of rapid sequences cannot be recommended as a substitute for spine-echo examinations.

Humans↗
PubMed1989

[Skeletal scintigraphic findings in spinal diseases].

Bone scanning and X-ray imaging are complementary diagnostic procedures providing different information on morphology and function. This is true for diseases of the spine. For further evaluation of lesions that have already been localized, bone scanning should be performed after X-ray examinations if any questions are still open (e.g., extent of disturbed bone metabolism, viability, age of a spine fracture, response to therapy). Typical scintigraphic patterns specific for few bone diseases are exceptional, being confined to Paget's diseases and degenerative changes in the cervical spine. As a first imaging modality, however, bone scanning should be employed in the follow-up of patients with malignancies and the probability of bone metastases. In a second step, bone lesions identified by scintigraphy should be checked by X-ray imaging. In this order and context, the high sensitivity of bone scanning and the high specificity of X-ray imaging optimize the accuracy of the diagnoses achieved with the different radiological modalities.

Bone and Bones↗
PubMed1986

[Single photon emission computed tomography of patients with benign and malignant spinal diseases].

SPECT has been used in a comparative study with planar bone scintigraphy in 54 patients. Spatial resolution of the method is sufficient to localise the vertebral bodies, the spinous processes, the intervertebral, costotransverse and costovertebral joints. In all patients it was possible to relate the areas of increased uptake to specific anatomical sites of the spine known to be affected in the different conditions. A detailed localisation is rarely possible using planar scintigraphy alone, due to the complex osseous anatomy of the spine. In some patients lesions could be seen only with SPECT. SPECT is an invaluable supplement to planar scintigraphy of the spine.

Adult↗
PubMed1984

Spontaneous degenerative spinal disease in the laboratory rabbit.

The spines of 35 rabbits (32 New Zealand white and 3 AC/J), ranging in age from 3 months to 8 1/2 years, were investigated systematically for spontaneous degenerative changes. Three types of lesion were observed. (1) The nucleus pulposus underwent chondroid metaplasia throughout the length of the vertebral column by the age of 2 years. (2) Hydroxyapatite deposition was found in the nucleus pulposus in 12 of 20 animals examined roentgenographically. The lesion occurred principally in the distal thoracic segments and was first observed in 3-month-old rabbits. (3) Spondylosis occurred in each of four macerated spines from animals greater than 24 months old. Portions of the spine spared by disc calcification were affected.

Age Factors↗
PubMedDate not supplied

SPIR MRI in spinal diseases.

We report on our experience with the fat suppression technique of spectral presaturation with inversion recovery MR in imaging certain spinal disorders. This technique may assist in demonstrating or excluding the presence of fat within a lesion (such as lipoma, dermoid, teratoma) or within a normal structure (i.e., vertebral body or epidural space). The method can also be used to suppress normal fat (such as marrow or epidural fat) thus increasing the conspicuity of adjacent high signal intensity lesions seen on T1-weighted images (such as blood and contrast-enhancing tumors or inflammatory lesions).

Abscess↗
PubMed2000

Outcome in Cloward anterior fusion for degenerative cervical spinal disease.

The Cloward ventral interbody fusion is often employed for treatment of cervical degenerative disease. The present study was aimed at evaluating results and complications in this classical type of autologous bone graft procedure in a cohort of patients with radiculopathy (RP) or myeloradiculopathy (MRP). Indications for and limitations of the technique were investigated by retrospective data analysis in a series of 106 patients (30 females and 76 males). These underwent single or multiple level Cloward fusion in a total of 145 levels. Neuroradiological investigations included lateral and antero-posterior cervical spine X-rays, axial CT scans, and MRI. The presence of postoperative ossification and stable bony fusion in the fused segments was confirmed by X-rays and, when necessary, by CT. The median postoperative follow-up period was 6.5 years (range 4-10.5 years). Short term outcome in RP patients was good in 26 cases (92.9%) and fair in 2 cases (7.1%). A good short term outcome was seen in 55 MRP patients (70.5%), a fair outcome in 20 patients (25.6%), and a poor outcome in 3 patients (3.8%). Patients having myelopathy signs for less than 1 year had a significantly better outcome than those with clinical signs for more than 1 year (p < 0.05). MRP patients below the age of 40 years had a significantly better outcome than those above the age of 40 (p < 0.05). In the long term, radiculopathy was cured or significantly improved in 92.8% of cases, and myeloradiculopathy in 64%. One year after surgery, there were 139 stably fused segments (96%) and 6 segments showing osseous non-union (4%). Plain lateral radiographs demonstrated, besides the bony fusion in the respective segment, relatively frequent graft collapse with slight to severe correction losses and kyphotic deformity of the cervical spine. However, these findings did not necessarily correlate with the clinical outcome. Autologous bone graft harvesting caused a rather high short-term morbidity with donor site pain and/or wound haematoma in 33% of the cases. These surgery-related complications, however, were of a temporary nature, as long-term complications (cutaneous hypaesthesiae) were found in 2 patients (1.8%) only. In conclusion, Cloward anterior cervical fusion for degenerative spinal disease is a relatively simple and safe surgical procedure with favourable short and long term results. In our hands, graft donor site complications dominate the side effects of surgery, and the percentage of non-unions is rather low. Because of the relatively frequent bone graft collapse and the late loss of postural correction of the spine, we cannot recommend the Cloward type fusion for multisegmental procedures. In such cases, an instrumented plate fusion should be carried out in order to prevent graft collapse and non-union, and to allow for a shorter convalescence period.

Adult↗
PubMed1993

[Spinal diseases: vertebral complaints in relation to site and age].

Disorders of the vertebral column are one of the most common causes of pain in the human being. The nosological classification of various disorders is carried out according to many different criteria, e.g. topical pain descriptions such as cervical syndrome and lumbago in particular, but more often also according to purely speculative factors such as intervertebral disc lesions, muscular rheumatism etc. The analysis of each single structural disturbance which could come into question is a primary function of the anamnesis, and in particular of the clinical examination, which must seek, respectively recognize signs not only of functional disturbances but also of functional devastations, in order to then objectify the structural devastation in particular using a number of different methods. The therapeutic consequences are drawn from the actual diagnosis, which must, above all, distinguish between the acute and the chronic symptoms, in order to then influence those as well as these symptoms in the foreground. Vertebral complaints express themselves in different ways depend on the age of the patient, a fact which must be taken into consideration when forming a diagnosis.

Adolescent↗
PubMed1991

Rehabilitation of patients with spinal cord disease.

Spinal cord injury and disease have multisystem consequences and many potential medical complications. This article addresses the various medical, psychosocial, and vocational issues associated with spinal cord injury and describes how the patient's lifestyle may be affected. The role of the physician and other rehabilitation professionals in the rehabilitation process is described. In addition, various medical concerns, complications, and available treatment modalities are discussed.

Humans↗