Revue de chirurgie orthopédique et réparatrice de l'appareil moteur
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Rev Chir Orthop Reparatrice Appar Mot · Jan 1989
Review Randomized Controlled Trial Clinical Trial[Lumbar facet joint syndrome. Significance of non-organic signs. A randomized placebo-controlled clinical study].
One hundred and nine patients with chronic (greater than 3 months) unilateral low back pain had less than or equal to 2/5 or greater than or equal to 3/5 inappropriate signs (IAS) in 65 and 44 cases, respectively. The patients were randomized in three therapy groups: cortison and local anaesthetic injected intra-articularly into two facet joints (28 patients), the same mixture injected pericapsularly around two facet joints as well (39 patients) and injection of physiologic sodium hydrochloride intra-articularly into two facet joints (42 patients). The effect of the treatment was evaluated within an hour, two and six weeks after the treatment with work status, pain scale, disability score and movements of the lumbar spine. ⋯ Identification of these patients may also prevent the doctor from a burn-out syndrome after many failed treatments. This study also shows that if a biological effect of a treatment is to be studied the patients with multiple IAS should be excluded from the material. There was no difference in the results when either intra-articular or pericapsular cortisone and local anaesthetic or saline intra-articularly was used.(ABSTRACT TRUNCATED AT 250 WORDS)
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Rev Chir Orthop Reparatrice Appar Mot · Jan 1988
Review[Chronic medullary neuro-stimulation in lumbosacral spinal arachnoiditis].
Between 1983 and 1986, 20 patients were treated by chronic spinal cord stimulation for the relief of pain. These patients suffered from lumbar arachnoiditis or root fibrosis causing lumbar pain and sciatica following operations for disc herniation or repeated radiculography. In this short series, the results obtained were satisfactory, with 12 good results which were stable over a 2-year period, thanks to careful selection of the subjects within the framework of a multidisciplinary pain clinic. The treatment of the fibrosis and the mechanism of neurostimulation are reviewed.
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Rev Chir Orthop Reparatrice Appar Mot · Jan 1987
[Aneurysmal bone cysts in children. Study of 28 cases].
Twenty-eight aneurysmal bone cysts in children aged between 3 and 16 years, with a mean follow-up of five years, have been reviewed. The diagnosis in these uncommon lesions was straightforward in 22 cases, based on the clinical, radiological and macroscopic features. The histological characteristics confirmed the diagnosis. ⋯ For the pathologist, the diagnostic problem is not so much from benign dystrophies, which are often difficult to distinguish from them, but from rare lesions in children, such as telangiectatic sarcoma, which have a more serious prognosis. The high recurrence rate, in four cases out of eleven, after curettage led to a preference for more radical treatment whenever possible, such as excision or resection, which was performed in 14 cases and which limited the liability to recurrence. Aneurysmal bone cyst is a benign tumour whose severity depends on its site, especially in the spine, where there is a risk of neurological complications, on its size, which may render surgical removal difficult and on its proximity to the growth plate, which may result in disturbance to growth which not infrequently occurs.
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Rev Chir Orthop Reparatrice Appar Mot · Jan 1987
[Ultrasonic and anatomical correlation of the normal hip in the newborn infant].
Ultrasound studies were made on the cadavers of seven normal new-born foetuses. The sonographic images obtained were compared with anatomical sections made in corresponding planes. An accurate analysis of the anatomy of the cartilaginous acetabular roof and labrum in these hips confirmed the accuracy of ultrasonography. Ultrasonography has made it possible to resolve certain doubts about the radiographic examination of infants between birth and the third month.