Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0003090 (arthrodesis)
 8,374 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In 39 cases of narrowed lumbar spinal canal associated with a scoliosis, the authors have studied the role played by deviation of the spine and the origin of the narrowing. It seemed that central stenosis with intermittent claudication was more frequent when a scoliosis was present. In more than half of the cases, the level of the compression was at the junction of the curves. After failure of conservative treatment, the surgical procedure performed was the same as in straight spines. The results were satisfactory in 90 p. 100 as regards root involvement and intermittent claudication. However 7 patients had increased low back pain after surgery, 3 of them being disabled. In young patients with curves of more than 30 degrees with noticeable rotation, straightening with arthrodesis appeared to be worthwhile rather than simple posterior laminectomy. In other cases a posterior liberation of the cord associated with limited posterolateral fusion is indicated.
 ...
PMID:[Lumbar stenosis with scoliosis. Symptomatologic study and surgical treatment of 39 cases]. 624 90

Fifty-eight patients with a variety of causes of chronic low back pain underwent posterolateral intertransverse process lumbar arthrodesis utilizing autologous iliac bone graft. The overall success rate of achieving fusion was 92%. Most of the failures occurred at the L4-L5 level. The economic and functional improvement as a result of this operation was between 70% and 80%, indicating that achievement of lumbar arthrodesis does not necessarily mean a successful surgical result. Overall improvement did not correlate specifically with levels of fusion or with performance of a laminectomy, but a history of prior low back surgery significantly lowered the success rate, regardless of achievement of a solid arthrodesis. Persisting discomfort at the iliac crest bone graft donor site somewhat lowered the overall improvement rate. Intertransverse process lumbar arthrodesis appears to be a highly satisfactory and perhaps a superior method of achieving lumbar fusion, when arthrodesis is indicated.
 ...
PMID:Intertransverse process lumbar arthrodesis with autogenous bone graft. 700 17

The results of lumbar diskectomy for a sciatic syndrome in 90 patients were reviewed at an average of 8.5 years after operation. The best results were achieved in those patients who had their diskectomy within 12 months of the onset of their symptoms and through minimal approaches. Eighty-six percent of patients returned to gainful employment. Sixteen patients (18%) returned with low back pain attributable to the loss of intervertebral disk, of whom eight (9%) required secondary spinal fusion for control of pain. Seven of these latter patients obtained gratifying clinical and functional results. The findings suggest there is insufficient indication for routine spinal arthrodesis combined with lumbar disk excision. Those eight patients (9%) who developed a disabling postdiskectomy/postlaminectomy instability syndrome did so usually as a consequence of excessive bone and ligament excision and benefitted significantly from subsequent spinal arthrodesis.
 ...
PMID:Should fusion accompany lumbar diskectomy? A medium-term answer. 815 69

The frequency and type of involvement of the sacroiliac joints in rheumatoid arthritis (RA) is a controversial issue. In this study we compared sacroiliac plain radiographs of 120 RA patients and 106 age and sex-matched primary osteoarthritis (OA) patients. Nobody had a history of low back pain. On the basis of the radiologist's report, sacroiliac alterations were found in 24 (20.0%) RA patients (subchondral sclerosis in 20, joint space narrowing in 2, bone erosions in 1 and bone ankylosis in 1) and in 13 (12.3%) OA patients (subchondral sclerosis in all). Neither the frequency nor the radiographic pattern of alterations were significantly different between the two groups. We conclude that radiographic changes of the sacroiliac joints in RA are mostly of degenerative nature not differing from those found in a OA control population.
 ...
PMID:[The involvement of the sacroiliac joints in rheumatoid arthritis. A retrospective radiographic study]. 818 99

Gait analysis could be a good objective and quantifiable assessment of function in patients with chronic low back pain. A study of the gait parameters of 20 normal subjects and 30 patients with low back pain, before and 2 years after surgery (mainly spinal arthrodesis) was undertaken. For the majority (67%) of patients, postoperative gait analysis confirmed their perception of pain and function. In a minority (33%) of patients, there was an improvement in gait parameters, despite the perception of continuing severe pain and poor physical functioning. It may be possible to reduce the number of patients experiencing symptomatic failure with surgery if this discrepancy between gait and disability due to pain can be discovered preoperatively. Then the advice against surgery could be given when indicated.
 ...
PMID:Gait analysis of patients with low back pain before and after surgery. 823 15

Forty-five patients with low back pain (LBP) of longer than six months' duration and for whom all conservative therapies failed were placed in a pantaloon cast for a two- to four-week trial period. Significant pain relief occurred in 31 (69%) of these patients. Of these 31, 23 patients were treated with spinal arthrodesis using lateral, intertransverse process fusions with iliac bone grafts. Before fusion, the painful lumbar segments were determined by facet analgesic blocks or the normal saline acceptance test. After an average follow-up period of 14 months, 17 (74%) had significant pain relief. The pantaloon cast may be an effective tool for identifying those chronic LBP patients who might benefit from spinal stabilization procedure.
 ...
PMID:Use of the pantaloon cast for the selection of fusion candidates in the treatment of chronic low back pain. 845 28

Six cases of ankylosing spondylitis (AS) complicated with acute anterior uveitis (AAU) were reviewed. Clinical and radiologic findings of these cases were correlated with HLA-B27. All the patients were men; four of them were HLA-B27 positive, and two were B27 negative. The average age of onset was younger in B27+ patients than in B27- patients. Ophthalmologic study showed no definite difference in inflammatory change of AAU between B27+ patients and B27- patients. AAU in B27+ patients was completely cured in three months. A history of low back pain was more apparent in B27+ than in B27- patients. Three out of four B27+ patients showed complete bony ankylosis in sacroiliac joints, whereas no ankylosis was seen in B27- patients. CT scan was useful to demonstrate sacroilitis in cases with equivocal radiologic findings. Spondylitic changes were more extensive in B27+ than in B27- patients. The results support the concept that HLA-B27+ AS and B27- AS are different entities with similar phenotypic expression, and HLA-B27 is an arthritogenic gene in the Japanese population as well.
 ...
PMID:[Ankylosing spondylitis with acute anterior uveitis--correlation between HLA-B27 and clinical and radiologic findings]. 849 71

This study retrospectively reviewed the outcomes of 17 patients with postlaminectomy lumbar instability treated by transpedicular reduction and stabilization. The criteria of instability were defined strictly by both the clinical symptom of "instability catch" and the radiological findings that fulfilled Nachemson's criteria. Low back pain and/or sciatica that interfered largely with the patients' work or quality of life were the indications for this treatment. All the operations were performed by one surgeon with the same spinal instrumentation system-"AO internal fixator". The follow-up period was between 16 and 36 months (mean 24 months). Face to face questionnaire revealed that this treatment modality is encouraging. Fourteen patients (82%) had complete or nearly complete relief from all the pre-operative symptoms. Two (12%) had partial relief of the symptoms that required a subsequent discectomy or wider laminectomy. Only one case (6%) with osteoporosis remained unchanged after the operation. On the follow-up radiographs, sixteen patients (94%) showed good alignment and solid arthrodesis of the treated motion segment. These radiological findings correlated quite well with the absence of the clinical symptom of "instability catch". A common, but acceptable, complication found in this series was a variable degree of low back stiffness secondary to the instrumentation. Fracture of the screw was found in one patient and pull out of the screw was found in another patient. However, they did not elicit detectable symptoms. Osteoporosis, concomitant disc herniation and persistent spinal stenosis at/or adjacent to the operated level were the three main factors that may contribute to unsatisfactory results secondary to this treatment. These problems remain to be resolved in the future.
 ...
PMID:Transpedicular reduction and stabilization for postlaminectomy lumbar instability. 868 36

Thirteen male patients (average age, 15.6 years) underwent intraarticular hip arthrodesis for unilateral disabling hip disease. Follow-up averaged 6.6 years. Seven patients had excellent or good Harris hip scores. Ten patients had low back pain, and seven patients had knee pain on the side of the fused hip. Limb-length discrepancy averaged 3.7 cm. A progressive hip adduction drift (average, 7 degrees) occurred during follow-up. Patients whose hips were fused in a position of 20-25 degrees flexion and whose limb-length discrepancies were < 2 cm had significantly lower incidences of back pain. Cybex muscle testing revealed significantly decreased quadriceps strength (29%) on the hip-fusion side. Gait laboratory analysis demonstrated decreased velocity, stride length, and cadence. There were two mildly symptomatic nonunions. Based on these results, we recommend that the hip fusion be positioned in 20 degrees flexion and 0 degree abduction. The joint must be completely debrided down to viable bone to maximize chances for union. Maintaining a limb-length discrepancy of < 2 cm is essential to minimize the incidence of low back pain, quadriceps deficiency, and abnormal gait parameters.
 ...
PMID:Intermediate follow-up of a simple method of hip arthrodesis in adolescent patients. 874 51

Hip arthrodesis remains an option for treatment of severe arthritis in young persons resulting primarily from osteonecrosis, congenital dysplasia, and joint sepsis. The authors reviewed six patients who underwent fusions as young adults (average age: 30.8 years) with an average follow-up period of 11.7 years. Solid arthrodesis without infection was noted in all cases. Patients who worked returned to prior employment without limitation. All patients complained of symptomatic low back pain and felt ambulation was limited by ipsilateral knee pain. Five of six noted impaired sexual function; although childbearing was not affected in one case. Four of six were satisfied with the operation, but only three of six would undergo it again given the alternative of total joint arthroplasty.
 ...
PMID:Hip fusion in young adults. 878 20


<< Previous 1 2 3 4 5 6 7 Next >>