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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

From January, 1979 to May, 1989, 107 patients with problems related to anterior cruciate ligament (ACL) were treated in our hospital. 100 of the patients had anterior cruciate ligament injury confirmed by arthrotomy or arthroscopy. The remaining 7 patients were found to be normal either by arthroscopy or arthrotomy. 29 patients had fresh ACL injury and 71 old. All the patients had history of trauma of the knee joint. Swelling and pain in the affected knee joint took place in fresh cases and few of them complained of instability or deformity of the knee. On examination, floating patella test was positive in the majority of the fresh cases. It was shown that accurate diagnosis could be made by Lachman test rather than by conventional anterior drawer test in dealing with fresh injury, but with old ones, Lachman test didn't show the advantages. Examination under anesthesia or arthroscopy helped a lot in diagnosing fresh ACL injury. Anterior drawer test (ADT) was significant in determining the existence of ACL injury. When ADT was positive, ACL injury was found in the majority of the cases, however, injured ACL couldn't be ruled out by negative ADT only. Positive valgus stress test on 0 degrees position suggests possibility of ACL injury, even ADT was negative. Despite the negative anterior drawer test positive posterior drawer test on three directions indicated the injury of the posterior cruciate ligament and the anterior cruciate ligament. The positive rate of ADT was higher than that of pivot shift test in dealing with anterior cruciate ligament injury. Positive pivot shift test suggests ACL injury.
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PMID:[Diagnosis of anterior cruciate ligament injury of the knee joint]. 149 17

Anterior lumbar interbody fusion was performed as the primary surgical procedure for 36 patients with internal disc derangement. Patients were selected on the basis of clinical complaints, discography, and magnetic resonance imaging results. Twenty-eight patients underwent a one-level fusion and eight patients had a two-level fusion for a total of 44 levels. Autogenous graft was used in all cases. Clinical results were categorized as success or failure based on return to work or activities of daily living, drug usage patterns, and complaints of pain. Thirty-one patients (86.1%) had a successful clinical result and five patients (13.9%) had an unsuccessful clinical result. Based on flexion-extension radiographs fusion was achieved in 32 patients (88.9%). Forty of the forty-four levels (90.9%) fused. Complications include one each of: pulmonary embolus, retrograde ejaculation, wound hematoma at the donor site, and perioperative graft extrusion.
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PMID:Anterior lumbar interbody fusion for internal disc disruption. 150 49

The purpose of this study was to evaluate the surgical results of anterior cervical discectomy and fusion using a countersunk interlocking autogenous iliac bone graft. Two hundred thirty-two patients were followed for an average of 6.8 years. All patients suffered neck and arm pain. Two hundred twenty patients received conservative treatment for at least six months. Overall results were satisfactory in 202 patients (87%) and unsatisfactory in 30 patients (13%). The pseudoarthrosis rate was 6.5% which is significantly lower than previous reports. The premise of this technique is that the interlocking graft prevents migration, promotes fusion by providing immobilization, and restores the height of the interspace. Anterior cervical discectomy and fusion, using a countersunk interlocking autogenous iliac bone graft, is a satisfactory surgical procedure in which successful pain relief is to be expected.
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PMID:Surgical results in anterior cervical discectomy and fusion using a countersunk interlocking autogenous iliac bone graft. 150 67

Forty patients underwent 47 procedures for repair of a lumbar pseudarthrosis at the University of Minnesota, Twin Cities Scoliosis Center between 1973 and 1986. Forty-three procedures in 36 patients with a minimum follow-up of 2 years were reviewed. Symptoms at the time of surgery included back pain (100%), leg pain (61%), subjective neurologic symptoms (49%), and thigh pain (35%). The diagnosis was made most commonly on the basis of pain radiographs (70%). In 38 cases, posterolateral fusion was performed, using segmental sublaminar wiring in 37%, a variable screw plate in 29%, Harrington compression rods in 16%, and no implant in 18%. Anterior interbody fusion was performed in six cases, including one combined fusion. Follow-up averaged 4.4 years. Solid fusion was achieved in 49% of cases. Eighty-six percent of patients continued to have low-back pain. Clinical outcomes were graded as excellent in 7%, good in 35%, fair in 9%, and failure in 49%. Significantly improved results were seen in patients in whom a solid fusion was obtained (p less than 0.005), in patients who had undergone only one prior surgery on the lumbar spine (p less than 0.01), and in patients in whom the initial fusion had been performed for spondylolisthesis rather than a primarily degenerative disorder (p less than 0.025). A trend toward better results was seen in cases in which the patient did not complain of leg pain preoperatively, in which a Workers' Compensation claim was not involved, and in which a prior attempt at pseudarthrosis repair had not been performed.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Results of lumbar pseudarthrosis repair. 153 4

Anterior cervical fusion utilizing an iliac-crest graft is often associated with pain at the donor site and graft collapse or dislocation. These problems were overcome by a surgical technique using circular fresh-frozen fibular grafts. This provides the strongest possible graft, and affords an opportunity to combine autogenous with homologous bone. There is minimal risk of infection, and the grafts can be soaked in an antibiotic solution as an added precaution. The technique is relatively easy, and postoperative results with regard to graft integrity, restoration of function, and resolution of pain are excellent.
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PMID:The use of fibular grafts with anterior cervical fusion. 156 26

A retrospective review of 13 patients who underwent decompression and transpedicular instrumentation for lumbar burst fractures is presented. Average follow-up was 22.5 months. Eighty-four percent of patients reported little or no pain at follow-up. Sixty-nine percent of patients returned to full preinjury activity. Radiographic review demonstrated an average postoperative progression of kyphosis of 8.7%. Anterior vertebral body height was unchanged between preoperative evaluation and follow-up. Although short-segment posterior transpedicular instrumentation with VSP plates did not reestablish or maintain anatomic alignment of the lumbar spine after burst fractures, the clinical outcome was excellent.
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PMID:Transpedicular short-segment fusions for treatment of lumbar burst fractures. 160 76

We report a prospective evaluation of the effect of anterior retinal cryopexy on 62 eyes with neovascular glaucoma. Pain was relieved and anterior chamber inflammatory reaction regressed dramatically in 95%. Iris neovascularization was reduced or regressed in 93.5%. Control of intraocular pressure was clinically significant in 82.3% 1 year after the procedure, especially in patients with pretreatment pressures less than 40 mm Hg on maximal medical therapy. Anterior retinal cryopexy is recommended in eyes with media opacities and as a preliminary procedure for filtering surgery in eyes with neovascular glaucoma.
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PMID:A prospective evaluation of anterior retinal cryoablation in neovascular glaucoma. 171 28

Anterior sacral anatomy was studied to allow safe sacral screw placement. The study included 27 bony sacra. Intrapelvic dissections were performed. Cadaveric specimens were dissected and photographed. The position and angulation of the first sacral foramen was extremely variable. After the position of the L5 root, sacral roots, and iliac vessels, was considered, safe posterior sacral screw implantation could be assured through placement above the level of the first sacral foramen directed medially toward the promontory, parallel to the superior sacral end-plate. Complications of indiscriminate screw placement included L5-root damage, iliac vein penetration, and intractable perineal pain due to sacral root injury. Preoperative computed tomography with the scanner gantry tilted to parallel the superior sacral end-plate defined the great vessels, neural foramens, inclination of the superior sacral end-plate, and prominence of the posterior ileum. Surgical accuracy was evaluated after surgery with computed tomography.
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PMID:Surgical anatomy of the sacrum. A guide for rational screw fixation. 186 26

Forty-five patients underwent surgical reconstruction with transpedicular fixation of the lumbar spine with narrow AO DCP plates. Preoperatively, all patients underwent spinal imaging with either magnetic resonance imaging, computed tomography, or myelogram as well as provocative discography to determine the location and the number of symptomatic segments. The minimum follow-up in this series was 2 years. The determination of solid posterior fusion in the presence of plate instrumentation was difficult. The patients in the series were classified as having 1) solid fusion; 2) radiographic flaws within the posterolateral fusion without implant failure; or 3) frank pseudarthrosis with implant failure. Thirty-six (80%) of the patients had a solid fusion, 9 of whom required an additional anterior interbody fusion to obtain symptom control. Twenty percent of the patients in the series had radiographic evidence of reabsorption without implant failure. Four patients in the series (8.8%) had screw breakage, three of which required anterior interbody fusions. The highest rate of reabsorption and pseudarthrosis implant failure was in the 12 patients who had three-level instrumentation; 33% of these patients required anterior interbody fusion to obtain a solid arthrodesis. The average preoperative pain scale was 8.9, and the average postoperative pain scale was a 3.3. Twenty-two patients in the series were cigarette smokers and had a slightly lower fusion rate than non-smokers. They did, however, have a higher use of narcotics after surgery. Forty percent of the patients in this series continued to have radiculopathy after their reconstruction. This study demonstrates the utility of transpedicular fixation in salvage lumbar surgery in obtaining a solid arthrodesis with a beneficial clinical result. Anterior interbody fusions are highly successful in the management of pseudarthrosis and implant failure after transpedicular instrumentation.
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PMID:Reconstruction of failed lumbar surgery with narrow AO DCP plates for spinal arthrodesis. 202 35

A specific pattern of injury to the superior labrum of the shoulder was identified arthroscopically in twenty-seven patients included in a retrospective review of more than 700 shoulder arthroscopies performed at our institution. The injury of the superior labrum begins posteriorly and extends anteriorly, stopping before or at the mid-glenoid notch and including the "anchor" of the biceps tendon to the labrum. We have labeled this injury a "SLAP lesion" (Superior Labrum Anterior and Posterior). There were 23 males and four females with an average age of 37.5 years. Time from injury to surgery averaged 29.3 months. The most common mechanism of injury was a compression force to the shoulder, usually as the result of a fall onto an outstretched arm, with the shoulder positioned in abduction and slight forward flexion at the time of the impact. The most common clinical complaints were pain, greater with overhead activity, and a painful "catching" or "popping" in the shoulder. No imaging test accurately defined the superior labral pathology preoperatively. We divided the superior labrum pathology into four distinct types. Treatment was performed arthroscopically based on the type of SLAP lesion noted at the time of surgery. The SLAP lesion, which has not been previously described, can be diagnosed only arthroscopically and may be treated successfully by arthroscopic techniques alone in many patients.
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PMID:SLAP lesions of the shoulder. 2067 11


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