Spine
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Case Reports
Localization of foreign bodies in the spinal canal by computer-assisted biplanar digitizer.
This study is a report of the use of a computer-assisted biplane digitizer to locate shotgun pellets within the spinal canal in an incompletely paralyzed patient. It was necessary to determine if one or more shotgun pellets were located within the spinal cord of the patient. Because of the profusion of pellets it was not possible to determine which, if any, of the pellets were in the spinal canal by routine roentgenograms. ⋯ This report presents the method for localizing foreign bodies and discusses the results of the procedure. It was concluded that the described method successfully located the position of pellets with respect to the spinal column and cord. This method may be useful for locating metallic fragments that have to be surgically removed in other patients sustaining spinal cord injury secondary to single missile wounds.
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Twenty patients with intractable, postoperative, recurrent low-back pain were treated with a sequential, epidural injection of morphine (8 mg) and methylprednisolone acetate (80 mg). Concomitantly administered, these drugs provided 50-100% pain relief lasting 6-24 months and elicited prolongations of mood elevation and morphine-induced side effects. Evidence from computed tomography and electromyography, however, indicated no amelioration of pre-existing pathologies.
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Comparative Study
The rate of pseudarthrosis (surgical nonunion) in patients who are smokers and patients who are nonsmokers: a comparison study.
To investigate the relationship of smoking with the rate of pseudarthrosis (surgical nonunion), 50 patients, who were smokers, and 50 patients, who were not, and who had had a two-level laminectomy and fusion during 1977 and 1978 were randomly selected for this study. Most of those participating had sustained job-related injuries whereas the others had no common etiology for their back dysfunction. Most of the patients were from the southeastern United States. ⋯ It was hypothesized that the higher incidence of surgical nonunion among smokers may be related to blood gas levels. Nonsmokers showed no significant deficiencies, whereas smokers showed a mean PO2 level of 78.5% (normal = 95-97) and a mean O2 saturation level of 92.9% (normal = 95 or above). Implications and suggestions for further research are also discussed.