The protective effect of CDP-choline in spinal cord transection and the mediation of its cardiovascular effects were investigated. Spinal cords of rats were transected at the T1-T2 levels. CDP-choline (250 mg/kg; intravenous) was... more
The protective effect of CDP-choline in spinal cord transection and the mediation of its cardiovascular effects were investigated. Spinal cords of rats were transected at the T1-T2 levels. CDP-choline (250 mg/kg; intravenous) was administered 2 h and/or 24 h after the injury. Spinal cord transection caused severe tissue damage, decreased mean arterial pressure, heart rate, plasma adrenaline, and noradrenaline but increased plasma vasopressin levels. Repeated CDP-choline treatment attenuated the degree of tissue injury. Administration of CDP-choline at 2 h after transection transiently increased blood pressure and decreased heart rate, while it produced a small decrease in blood pressure and heart rate when it was given at 24 h. Plasma adrenaline levels were higher in the group where CDP-choline was given repeatedly. Plasma noradrenaline and vasopressin levels did not change additionally after CDP-choline injections in all groups. In order to determine if CDP-choline attenuates the o...
To compare two groups of worker with and without upper limb musculoskeletal symptoms when simulating handling tasks, regarding trunk movements and load support. Simultaneous lumbar movements and load support were quantified by a flexible... more
To compare two groups of worker with and without upper limb musculoskeletal symptoms when simulating handling tasks, regarding trunk movements and load support. Simultaneous lumbar movements and load support were quantified by a flexible electrogoniometer and load cell, respectively. Workers can adopt different motor strategies to perform similar tasks, possibly resulting in different physical demands. No previous studies on different movement patterns as a possible strategy for coping with physical demands by injured workers are available. 9 asymptomatic and 10 symptomatic industrial workers, carried a device for measuring contact between load and trunk during simulated tasks. An ANOVA was performed to compare results between symptomatic and asymptomatic workers. Most of the symptomatic workers supported the load on their trunk, whilst most of the asymptomatic workers did not. Higher values of lumbar flexion occurred for the symptomatic workers (P<0.05). Apparently, differences in movement and load support were adopted by injured workers as a possible strategy to share upper limb overload with other body regions. Workers suffering from work-related musculoskeletal disorders may adopt different motor strategies to cope with their job physical demands. An effort should be made to reallocate injured workers if major cost is to be avoided.
Diagnostic testing. The goal of this study is to measure the accuracy and reliability of the Orthoscan (Orthoscan Technologies, Inc.) and to determine whether it can be substituted for radiographs in the surveillance of adolescent... more
Diagnostic testing. The goal of this study is to measure the accuracy and reliability of the Orthoscan (Orthoscan Technologies, Inc.) and to determine whether it can be substituted for radiographs in the surveillance of adolescent idiopathic scoliosis (AIS). AIS is usually followed using scoliosis radiographs, which offer the most reliable way to quantify the curve, but carry the risk of exposure to ionizing radiation. The Orthoscan is a nonradiographic topographic method for measuring spinal curves. There were 5 phases of this study that measured: the accuracy and reliability of the machine when used with a plastic model; the variability with a real patient; the intraobserver variability; the correlation between the measurements of the machine and that of the radiograph; and the correlation between the change in radiograph measurement over time and the change in Orthoscan measurement over time. In measurement of a static plastic model, the machine measured curves with a standard de...
Pyogenic spondylodiscitis associated with epidural abscess is a rare but serious problem in spinal surgery, because it may cause a severe morbidity or mortality, if the diagnosis is established late and the treatment is inadequate. A case... more
Pyogenic spondylodiscitis associated with epidural abscess is a rare but serious problem in spinal surgery, because it may cause a severe morbidity or mortality, if the diagnosis is established late and the treatment is inadequate. A case of pyogenic thoracic spondylodiscitis associated with epidural abscess whose symptoms progressed over two months from back pain to acute paraplegia was presented. Magnetic resonance imaging of the spine suggested the presence of T9–10 spondylodiscitis with partial destruction of the T9 and T10 vertebral bodies and concomitant epidural abscess. Treatment consisting of surgical debridement of infected vertebrae and disc material, fusion and anterior spinal instrumentation was performed. Microbiological culture of the material revealed infection with Staphylococcus aureus and after 3 months of antibiotic treatment, recovery was almost complete. Based on a thorough review of the literature and the case presented in this report, it is concluded that accurate and prompt diagnosis requires high index of suspicion followed by a combination of adequate surgical and conservative treatment prevents severe morbidity in cases of nonspecific pyogenic spondylodiscitis associated with epidural abscess.
We reviewed retrospectively our patients with thoracic lordoscoliosis and conducted a conceptual analysis of the patients with airway compression and atelectasia due to anterior protrusion of the vertebral bodies in order to describe the... more
We reviewed retrospectively our patients with thoracic lordoscoliosis and conducted a conceptual analysis of the patients with airway compression and atelectasia due to anterior protrusion of the vertebral bodies in order to describe the pathological conditions involved and the management methods used. Our goal was to develop a new concept for quantifying thoracic deformation. The individual cases discussed here have been reported earlier, but this is the first series analysis to date. Eighteen patients, aged 7.3 to 18 years, with thoracic lordoscoliosis due to a variety of causes, mostly neuromuscular disorders (12 cases), are described. Most patients were treated by anterior subtotal periosteal resection of the vertebral body followed by posterior instrumentation and arthrodesis. Atelectasia disappeared with a normalization of blood gases but the effect was variable on vital capacity. The analysis of the CT studies led to the concept of spinal deformity as an endothoracic deformat...
Preparation for surgery for thoracic intraspinal lesions commonly involves rather difficult X-ray procedures in the operating room. The object of this report is to inform neurosurgeons about a modified technique for preoperative surface... more
Preparation for surgery for thoracic intraspinal lesions commonly involves rather difficult X-ray procedures in the operating room. The object of this report is to inform neurosurgeons about a modified technique for preoperative surface localization of intraspinal thoracic pathology. Adhesive, disposable radiographic skin markers placed at the presumed level of an intraspinal lesion are visualized along with the lesion on sagittal magnetic resonance scans of the thoracic spine. The lesion and the skin markers were clearly identified within the same field of view. The lesion itself rather than the vertebral body becomes the reference point for localization. Preoperative imaging with adhesive skin markers facilitates positioning and draping for surgery for thoracic intraspinal lesions. It may even replace intra-operative X-ray procedures in selected cases.
To describe a technique for thoracolumbar lateral corpectomy and to evaluate its use for treatment of chronic thoracolumbar disk disease in dogs. Retrospective study. Fifteen dogs with signs of chronic thoracolumbar disk herniation. After... more
To describe a technique for thoracolumbar lateral corpectomy and to evaluate its use for treatment of chronic thoracolumbar disk disease in dogs. Retrospective study. Fifteen dogs with signs of chronic thoracolumbar disk herniation. After a dorsal or lateral approach to the spine, a lateral slot was created in 2 adjacent vertebral bodies on either side of the herniated disk and extruded/protruded material was removed. Data collected included history, duration of clinical signs, presurgical assessment of neurologic status, postsurgical neurologic status, complications, and outcome. Ambulatory capacity was maintained or regained, and neurologic status improved by 1 grade (3 dogs), 2 grades (8), 3 grades (2), or 4 grades (2). Eleven dogs were considered free of disease. A seroma in 1 dog was the sole complication observed. Lateral corpectomy permits relatively easy removal of protruded-extruded disk material from within the vertebral canal in chronic disk disease without further iatrogenic injury to the spinal cord. Lateral corpectomy is an alternative to dorsal decompression for treatment of ventral and lateroventral thoracolumbar chronic disk disease in dogs.
To summarize the current knowledge relating to diagnosing and treating Scheuermann's disease. Scheuermann's disease is the most common cause of structural kyphosis in adolescence. A literature-based narrative review of English... more
To summarize the current knowledge relating to diagnosing and treating Scheuermann's disease. Scheuermann's disease is the most common cause of structural kyphosis in adolescence. A literature-based narrative review of English language medical literature. Recent studies have revealed a major genetic contribution (a dominant autosomal inheritance pattern with high penetrance and variable expressivity) to the etiology of Scheuermann kyphosis with a smaller environmental component (most probably mechanical factors). The natural history of Scheuermann kyphosis remains controversial, with conflicting reports as to the severity of pain and physical disability. Since we cannot predict which kyphotic curves will progress, we are unable to determine effectiveness of brace treatment. Physical therapy is scarcely mentioned in the literature as an effective treatment for Scheuermann kyphosis. Although there is little evidence that physical therapy alone can alter the natural history of ...
The assessment of vertebral fracture by conventional radiography has been refined and improved using either semiquantitative or quantitative criteria. The inter- and intraobserver variability was determined for a semiquantitative visual... more
The assessment of vertebral fracture by conventional radiography has been refined and improved using either semiquantitative or quantitative criteria. The inter- and intraobserver variability was determined for a semiquantitative visual approach that we routinely use in clinical studies for assessing prevalent and incident vertebral fractures. In addition, the semiquantitative approach was compared with a quantitative morpho-metric approach. The incidence and prevalence of vertebral fractures were determined in 57 postmenopausal women (age 65–75 years) by three independent observers. The radiographic basis for fracture definitions and the source of interpretative errors are illustrated. The results show excellent intraobserver agreement and good interobserver agreement for the semiquantitative technique. We conclude that the semiquantitative approach can be applied reliably in vertebral fracture assessment when performed using well-defined criteria.
A follow-up of disc herniation (herniated nucleus pulposus [HNP]) resorption on magnetic resonance imaging (MRI). To assess the determinants of resorption of HNP. Neovascularization in the outermost areas of HNP, presenting as an... more
A follow-up of disc herniation (herniated nucleus pulposus [HNP]) resorption on magnetic resonance imaging (MRI). To assess the determinants of resorption of HNP. Neovascularization in the outermost areas of HNP, presenting as an enhancing rim in gadolinium diethylenetriamine pentaacetic acid MR images, is thought to be a major determinant of spontaneous resorption of HNP. Patients with HNP-induced sciatica at baseline were rescanned at 2 months (N = 74) and after 12 months (N = 53). The volume of HNP (mm), thickness (mm) and extent (%) of enhancement, and the degree of HNP migration (Komori classification) were analyzed. Repeated measures analysis of covariance was used in statistical analysis. Significant resorption of HNP occurred from baseline to 2 months, although the resorption rate was more pronounced over the whole 1-year follow-up. Higher baseline scores of rim enhancement thickness, higher degree of HNP displacement in the Komori classification, and age category 41-50 year...
In this letter to the Editor, an additional radiological thoracic deformity parameter is described, which was not included in the review, namely the rib index (RI). The index and its usefulness of its application are described, both in... more
In this letter to the Editor, an additional radiological thoracic deformity parameter is described, which was not included in the review, namely the rib index (RI). The index and its usefulness of its application are described, both in the clinical praxis and in the aetiology of idiopathic scoliosis. The pertinent literature is also sited.
