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Biomedical subjects

B L Rish

Publications and source records attributed to B L Rish.

At least 19 recordsLinked to original sources

A critique of posterior lumbar interbody fusion: 12 years' experience with 250 patients.

A comprehensive long-term follow-up analysis of the clinical and radiographic results of posterior lumbar interbody fusion for lumbar disk disease is presented. This 12-year experience with 250 patients is compared with a previous critique of our surgical management of lumbar disk disease by laminotomy and diskectomy alone. The clinical results and complications rates are comparable. However, posterior lumbar interbody fusion significantly reduces the rate of recurrent problems requiring subsequent surgery. Careful technique and judgment are mandatory for success with posterior lumbar interbody fusion. Homologous tissue bank bone grafts were found to be as successful as autogenous bone. Posterior lumbar interbody fusion represents an improvement in the surgical management of lumbar disk disease.

Humans

Mortality following penetrating craniocerebral injuries. An analysis of the deaths in the Vietnam Head Injury Registry population.

A population of 1127 men with penetrating craniocerebral injuries who were alive 1 week after their injuries has been followed for 15 years. During this time, 90 deaths (8%) occurred. Most of the deaths occurred early in the 1st year after trauma and were secondary to the direct effects of brain injury or the sequelae of coma. Complications, particularly infections, were significant mortality factors. Coma was the best prognostic guideline. Posttraumatic epilepsy was not related to mortality except for the risks accompanying each ictus. The population now appears to be approaching the actuarial norm of their peers.

Brain Injuries

Cranioplasty: a review of 1030 cases of penetrating head injury.

A total of 491 cranioplasties performed in a population of 1030 cases of penetrating head injury are reviewed. The morbidity rate was 5.5%, and the mortality rate was 0.2%. The clinical criteria of improving cosmetic defects and restoring craniocerebral protection are established, based on the location and size of the skull defect. Cranioplasty after penetrating head injury should be deferred for a minimum of 1 year to control morbidity. Complication of the original injury and surgical debridement increase the morbidity rate of cranioplasty. Post-traumatic epilepsy is not related to skull defects per se; neither is it affected by cranioplasty. Acrylic is an acceptable cranioplasty material if there is strict adherence to good surgical technique.

Acrylic Resins

Treatment of intracranial aneurysms associated with other entities.

Considering the current state of surgery for intracranial aneurysm, a philosophy for treating intracranial aneurysms associated with other entities is presented. The premise is based on a comprehensive review of the literature relative to the risk factors applied to intracranial aneurysms and personal experience in dealing with the combination of problems of aneurysms diagnosed in association with other intracranial aneurysms, vascular malformations, neoplasms, trauma, and inflammatory diseases. A patient's problem must be considered individually and comprehensively, using all known prognostic factors and the specific features of the case for an appropriate therapeutic regimen to be designed. Current mortality and morbidity rates warrant the surgical intervention for the incidentally diagnosed aneurysm, but the occurrence of an aneurysm in conjunction with another serious entity demands careful, comprehensive evaluation. The surgical challenge of these complex problems should take second priority to a careful therapeutic deliberation to promote the best final outcome.

Aortic Coarctation

Anterior cervical fusion using homologous bone grafts: a comparative study.

A comparative sutyd of homologous and autogenous bone grafts in Smith-Robinson type anterior cervical fusions reveals no significant difference between the two in clinical or radiographic results and no complications related to the use of the homologous grafts from the tissue bank.

Bone Transplantation