Spine
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Clinical Trial
Reduction technique for uni- and biarticular dislocations of the lower cervical spine.
A technical report concerning the methods of reduction of dislocations of the lower cervical spine used in 168 consecutive cases (77 unilateral and 91 bilateral dislocations). ⋯ This protocol consists of application of rapidly progressive traction, followed if necessary by one or two reduction maneuvers with the patient under general anesthesia. If both methods fail, specific surgical procedures using an anterior exposure seem to be reliable, in that anatomic reduction was obtained in 163 of 168 patients without neurologic deterioration.
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Clinical Trial
Effect of patient position and hypotensive anesthesia on inferior vena caval pressure.
This is a prospective study to measure the inferior vena caval pressure of 20 patients in different positions and different states of blood pressure. ⋯ A device allowing the patient's abdominaL viscera to hang freely while the patient is in a prone position significantly reduces their inferior vena caval pressure. The patients also has a constant inferior vena caval pressure during isoflurane-induced hypotension.
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The effect of epidural injection of betamethasone or bupivacaine was investigated in an animal model of lumbar radiculopathy. ⋯ Epidural steroid injection has a significant effect on the thermal hyperalgesia produced in a model of radiculopathy, which may provide clinical support for advocates of epidural steroids.
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Surgically obtained herniated lumbar disc specimens were stained with hematoxylin-eosin or toluidine blue (for detection of proteoglycans) or were immunostained with monoclonal antibodies (CD68), antihuman interstitial collagenase (matrix metalloproteinase [MMP]-1) and antihuman stromelysin (MMP-3). ⋯ The increased staining of MMP-1 and MMP-3 associated with inflammatory cells of granulation tissue in herniated discs suggests a causal correlation of these proteinases to tissue degradation in herniation.
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To evaluate the sensitivity of an electro-monitoring method in acute nerve root injury, and to determine a proposed criterion for irreversible electrophysiologic degradation. ⋯ It was concluded that spinal somatosensory-evoked potential can provide immediate feedback of nerve root injury and should be considered for use during the dynamic phase of transpedicular screw insertion.