Spine
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Cadaveric anatomic and in vivo survival animal studies were performed to develop a new arthrodesis technique for the lumbar spine. ⋯ Video-assisted lateral intertransverse process arthrodesis is a feasible, effective, and safe method of lumbar spinal fusion in the rabbit and rhesus monkey. Use of this arthrodesis procedure will minimize the morbidity of paraspinal muscle denervation and devascularization seen with open intertransverse process fusion techniques, and the use of an osteoinductive growth factor will eliminate the problem of graft donor site morbidity and possibly increase the chances for successful fusion.
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A survey of occupational risks for low back trouble in two police forces discordant for one known physical stressor (wearing body armor weighing approximately 8.5 kg. ⋯ Exposure to occupational physical stress seems detrimental; It reduced survival time to first-onset of low back trouble. Recurrence was associated with time since onset, but persistent trouble was not. Sports participation was a risk if occupational hazards were high.
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Intramuscular pressure and blood flow of the back muscles were evaluated topographically during posterior lumbar spine surgery. The topographic damage of the back muscle after surgery was studied. ⋯ The back muscles were exposed to pathophysiologic condition by a retractor during posterior lumbar spine surgery. External compression by a retractor increases intramuscular pressure to levels that impede local muscle blood flow. The muscle degeneration after surgery could be explained by direct mechanical damage and by the increased intramuscular pressure of muscle tissue by the retractor.
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To record prospectively combined motor- and somatosensory-evoked potentials in children during scoliosis surgery using Cotrel-Dubousset instrumentation, without using special anesthetic or muscle relaxant regimens. ⋯ A spinal cord monitoring system is described that is safe, reliable, accurate, and makes it unnecessary to resort to the "wake-up" test.