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  • 1
    ISSN: 1432-0932
    Keywords: Rachis dégénératif ; Fusion lombaire ; Ostéosynthèse ; Vissage translamaire des facettes ; Degenerative spine ; Lumbar fusion ; Internal fixation ; Translaminar facet screw
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary From 1984 to 1988, 70 consecutive lumbar and lumbosacral spine fusions enhanced with translaminar facet joint screws were performed for segmental degenerative disease. Twenty patients had partial decompression of central stenosis, 15 concomitant discectomy, and 19 lateral nerve root decompression. The mean time to fusion was 4.5 months (range 2–7 months). At follow-up (average 45 months; range 24–74 months) 98.5% were judged to have solid fusion. Satisfactory results were observed in 84% of cases, 91% without previous surgery and 75% after previous discectomy. Supplementation of posterolateral fusion by translaminar facet screws significantly improved time to fusion, fusion rate, and clinical outcomes with no significant increased complications.
    Notes: Résumé De 1984 à 1988, 70 arthrodèses lombaires et lombo-sacrées renforcées par un vissage translamaire des articulations interapophysaires ont été réalisées consécutivement pour des atteintes dégénératives segmentaires du rachis. Vingt patients ont eu dans le m^eme temps une décompression partielle pour sténose centrale, 15 une discectomie et 19 une décompression radiculaire latérale. Le délai moyen de fusion a été de 4,5 mois (valeurs extrêmes: 2–7 mois). A distance (délai moyen: 45 mois; valeurs extrêmes: 24–74 mois), 98,5% des patients présentaient une fusion stable. Les résultants satisfaisants ont été globalement observés dans 84% des cas, dans 91% des cas sans chirurgie préalable et dans 75% des cas après discectomie préalable. Le renforcement de la greffe postéro-latérale par le vissage translamaire des facettes améliore de manière significative de délai et le taux de fusion ainsi que les résultats cliniques, sans augmentation significative du taux des complications.
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  • 2
    ISSN: 1432-0932
    Keywords: Discographie ; Discomanométrie ; Disque intervertébral. Rachis lombaire ; Key words ; Discography ; Discomanometry ; Intervertebral disc ; Lumbar spine
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary A new discomanometry system was developed and evaluated for application in the lumbar spine. The diagnostic reliability of discography, manometry and discomanometry (a combination of both methods) was assessed in 20 lumbar cadaver spines (95 intervertebral discs) with regard to the diagnosis of non-contained intervertebral discs. The sensitivity was 92% for manometry and 78% for discography. This indicates that 22% of the non-contained discs could not be correctly identified with common discography. The specificity was 98% for manometry and 100% for discography, indicating that contained discs could be easily identified with both methods. A combination of manometry and discography provides a high sensitivity (98%) as well as high specificity (98%). It is concluded that discomanometry is a simple, cost-effective and reliable diagnostic procedure which can precede percutaneous nucleotomy without additional risks or relevant efforts. It allows the differentiation between contained and non-contained intervertrebral discs with a high degree of diagnostic reliability in an experimental setting, which justifies its further application in patients.
    Notes: Résumé Un nouveau système de discomanométrie a été développé et évalué afin d'être appliqué au rachis lombaire. La fiabilité diagnostique de la discographie, de la manométrie et de la discomanométrie (combinaison des deux méthodes) en matière de hernie discale, a été évaluée sur 20 rachis lombaires de cadavres (95 disques intervertébraux). La sensibilité était de 92% pour la manométrie et 78% pour la discographie. Cela indique que 22% des disques présentant une hernie ne pouvaient pas être identifiés par la discographie de routine. La spécificité était de 98% pour la manométrie et 100% pour la discographie, indiquant que les disques intacts pouvaient être aisément identifiés par les deux méthodes. Une combinaison de la manométrie et de la discographie assure une grande sensibilité (98%) ainsi qu'une haute spécificité (98%). En conclusion, la discomanométrie est un procédé diagnostique simple, économique et fiable que l'on peut pratiquer avant la nucléotomie percutanée sans risques ni efforts supplémentaires importants. Elle permet de distinguer les disques intervertébraux intacts des disques rompus avec une grande fiabilité diagnostique expérimentale, ce qui justifie son utilisation chez les patients.
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  • 3
    Electronic Resource
    Electronic Resource
    Springer
    European spine journal 6 (1997), S. 2-18 
    ISSN: 1432-0932
    Keywords: Pedicle screw fixation ; Fusion rate ; Outcome ; Indications Review
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Continuing controversy over the use of pedicular fixation in the United States is promoted by the lack of governmental approval for the marketing of these devices due to safety and efficacy concerns. These implants have meanwhile become an invaluable part of spinal instrumentation in Europe. With regard to the North American view, there is a lack of comprehensive reviews that consider the historical evolution of pedicle screw systems, the rationales for their application, and the clinical outcome from a European perspective. This literature review suggests that pedicular fixation is a relatively safe procedure and is not associated with a significantly higher complication risk than non-pedicular instrumentation. Pedicle screw fixation provides short, rigid segmental stabilization that allows preservation of motion segments and stabilization of the spine in the absence of intact posterior elements, which is not possible with non-pedicular instrumentation. Fusion rates and clinical outcome in the treatment of thoracolumbar fractures appear to be superior to that achieved using other forms of treatment. For the correction of spinal deformity (i.e., scoliosis, kyphosis, spondylolisthesis, tumor), pedicular fixation provides the theoretical benefit of rigid segmental fixation and of facilitated deformity correction by a posterior approach, but the clinical relevance so far remains unknown. In low-back pain disorders, a literature analysis of 5,600 cases of lumbar fusion with different techniques reveals a trend that pedicle screw fixation enhances the fusion rate but not clinical outcome. The most striking finding in the literature is the large range in the radiological and clinical results. For every single fusion technique poor and excellent results have been described. This review argues that European spine surgeons should begin to back up the evident benefits of pedicle screw systems for specific spinal disorders by controlled prospective clinical trials. This may prevent forthcoming medical licensing authorities from restricting the use of pedicle screw devices and dictating the practice of spinal surgery in Europe in the near future.
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  • 4
    ISSN: 1432-0932
    Keywords: Key words Arterial thrombosis ; Anterior lumbar interbody fusion ; Complication ; Vascular injury
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report a case of progressive thrombotic occlusion of the left common iliac artery in a 41-year-old woman after anterior interbody fusion, which initially presented only as a sensation of numbness. Diagnosis was delayed until complete arterial occlusion occurred 36 h after surgery. A sensory deficit may be the only early sign of a progressive thrombotic arterial occlusion. In anterior spinal surgery, routine postoperative vascular monitoring of the lower extremities is recommended and mandatory for early diagnosis and treatment of this rare complication.
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  • 5
    ISSN: 1432-119X
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Medicine
    Notes: Abstract  Type X collagen has so far not been reported to occur in human intervertebral discs. The objective of this study was therefore to investigate the occurrence of type X collagen in human lumbar intervertebral discs during ageing and degeneration. Ninety intervertebral discs with adjacent endplates were excised in toto from individuals (0–86 years) without known spinal disease and were processed for routine decalcified histology. Appropriate slices of each disc were processed for immunohistochemistry using a type-spec ific, monoclonal antibody raised against human type X collagen. Each intervertebral disc was examined for macroscopic and histomorphological features of disc degeneration. Immunohistochemically, a positive specific type X staining was observed in the hypertrophic zone of the growth plate and only in the interstitial matrix of juvenile (〈2 years) nucleus pulposus. In adult discs, type X collagen could be localized in conjunction with advanced disc degeneration and first occurred in the disc matrix (i.e., pericellular region) of a 47-year-old specimen. Positive type X staining of the disc matrix was more frequently found in senile (〉70 years) discs with end stages of disc degeneration. This study provides the first evidence for the occurrence of type X collagen in human lumbar intervertebral discs and it appears that type X collagen is re-expressed in late stages of disc degeneration.
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  • 6
    Electronic Resource
    Electronic Resource
    Springer
    European spine journal 6 (1997), S. 410-411 
    ISSN: 1432-0932
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
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  • 7
    ISSN: 1432-0932
    Keywords: Diagnostic imaging ; Lumbar spine ; Bias ; Efficacy ; Technology assessment
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract This review provides methodological background and some guidelines for the evaluation of imaging modalities for the lumbar spine and reviews the current literature on the basis of different levels of efficacy which consider standards beyond technical quality or diagnostic accurracy. From a MEDLINE search, 672 articles (1985–1995) were retrieved which focused on the development or application of imaging modalities for lumbar spinal disorders. The papers were categorized according to different efficacy levels at which the imaging modalities were assessed. This review has demonstrated that the vast majority of reports evaluate imaging studies for the lumbar spine only at the technical efficacy level. A minor proportion of the articles focus on the evaluation at the level of diagnostic accuracy. Articles which assess imaging studies on a higher level of efficacy (e.g., diagnostic and therapeutic impact, patient outcome and costbenefit analysis) are sparse. This review has outlined frequent methodological flaws in patient selection and design of imaging studies for the lumbar spine. The spine specialist should therefore become very critical in the interpretation of those studies and pay attention to patient selection and spectrum, choice of the reference standard, sample size, various forms of biases, and the reasoning behind clinical recommendations in order to improve his patient care.
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  • 8
    ISSN: 1434-601X
    Keywords: 35.10.F ; 21.10
    Source: Springer Online Journal Archives 1860-2000
    Topics: Physics
    Notes: Abstract The hyperfine structure, isotope and isomeric shifts in the atomic transition 6p 2 P 3/2−7s 2 S 1/2, λ=535 nm have been measured for theI=7 andI=2 states of190, 192, 194, 196Tl; theI=1/2 andI=9/2 states of191Tl and the I=7 isomer of188Tl. The thallium isotopes were prepared as fast atomic beams at the GSI on-line mass separator following fusion reactions and — in some cases — subsequentβ-decay. The nuclear dipole moments, electric quadrupole moments and the change in the nuclear mean square charge radius are evaluated. Theuu-isotopes show an isomeric shift which changes sign between192Tl and194Tl.
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  • 9
    ISSN: 1432-2161
    Keywords: Key words Benign bone tumour ; Chondromyxoid fibroma ; Spine ; Contiguous vertebrae
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  We report on a case of chondromyxoid fibroma involving two adjacent thoracic vertebrae with features of aggressive behaviour on radiographs, CT and MRI. Histology revealed typical chondromyxoid fibroma with unusually coarse calcifications. Chondromyxoid fibroma of the spine is rare, and only 30 of these tumours have been reported so far. Involvement of two contiguous vertebral bodies by chondromyxoid fibroma, as reported here, appears exceptional.
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  • 10
    ISSN: 1572-9540
    Source: Springer Online Journal Archives 1860-2000
    Topics: Physics
    Notes: Abstract Laser spectroscopy measurements have been carried out on very neutron-deficient isotopes of Au, Pt and Ir, produced as daughter elements from a Hg ISOLDE beam. For these transitional region nuclides, the hyperfine structure (HFS) and isotope shift (IS) were measured by Resonance Ionization Spectroscopy (RIS). Magnetic moments μ, spectroscopic quadrupole moments Qs and changes of the nuclear mean square charge radius δ〈rc 2〉along isotopic series have been extracted. For some results, a detailed comparison with theoretical predictions is presented.
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