The Orthopedic clinics of North America
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Orthop. Clin. North Am. · Apr 1991
ReviewMagnetic resonance imaging in the evaluation of low back pain.
Many observers believe that magnetic resonance has become the procedure of choice for lumbar spine imaging. This article includes discussions of technique, normal anatomy, degenerative disc disease, and the use of paramagnetic contrast agents. Numerous figures are provided to illustrate explanations.
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Orthop. Clin. North Am. · Apr 1991
The tissue origin of low back pain and sciatica: a report of pain response to tissue stimulation during operations on the lumbar spine using local anesthesia.
In an effort to define the origin of low back pain and sciatica, 193 patients were carefully studied using progressive local anesthesia. These patients had surgery for herniated discs, spinal stenoses, or both. Various tissues were stimulated during the performance of these lumbar spinal operations. This article discusses our observations and the results of that study.
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The concept of the Pauwels osteotomy seems to be a valuable method of treating nonunions of the femoral neck. If there is concomitant avascular necrosis, the involved area should be small and the patient younger than 60 years old.
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MRI is rapidly becoming the imaging modality of choice in the diagnostic assessment of patients with persistent or recurrent symptoms following spinal surgery. It displays the normal postoperative findings as well as most causes of FBSS. ⋯ This can be particularly helpful in evaluating the patient with multiple lumbar surgeries. MRI can also determine the presence of other causes of the FBSS such as lateral spinal stenosis, arachnoiditis, fat graft compression on the thecal sac, and presence of postoperative hematoma or postoperative infection.
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MRI is a useful diagnostic tool in the assessment of traumatic lesions of the foot and ankle. It is especially useful in demonstrating acute and chronic tendon and ligament injuries. ⋯ A bone scan may also be used to detect these fractures; however, with MRI the fracture extent may be determined. MRI is also useful in diagnosing complication of trauma, such as ischemic necrosis and bone and soft-tissue infections.