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Biomedical subjects

E S Stauffer

Publications and source records attributed to E S Stauffer.

At least 55 records · Page 3Linked to original sources
PubMed1976

Surgical stabilization of the cervical spine after trauma.

Surgical stabilization should be individualized for each patient. The procedure used should provide both immediate and prolonged stability at the site of instability. The choice of procedure depends on knowledge of the structures providing stability and of the mechanism of injury. Pure flexon injuries without comminution or disruption of ligaments are stable and do not require surgical treatment. Flexion-rotation dislocations, with either unilateral or bilateral facet dislocation, should be treated by posterior open reduction and fusion if they cannot be reduced by a closed method or if there is demonstratable motion on three-month flexion-extension roentgenograms. A comminuted burst ("teardrop") fracture produced by axial loading of the vertebral bodies should be stabilized by an anterior cortical strut graft for early mobilization and realignment of the spinal column to prevent progressive deformity.

Cervical Vertebrae↗
PubMed1976

Late instability in cervical spine fractures secondary to laminectomy.

Of 256 patients with a major spinal cord injury as a result of fracture of the cervical spine, 38 per cent had a laminectomy. Three months after injury, 33 per cent of the patients with laminectomy required fusion for instability compared to 22 per cent of the nonlaminectomy group. There were no cases of late instability in pure flexion or extension fracture groups. Ninety per cent of the late instability cases were in the groups with hyperflexion and flexion compression fractures. Laminectomy should be avoided for these fractures, but early fusion may be necessary to prevent progressive deformity.

Adolescent↗
PubMed1975

Spinal cord injury as a complication of elective anterior cervical fusion.

The true incidence of spinal cord injury as a complication of elective anterior discectomy and interbody fusion is not known. It would appear that the risk of encountering this complication increases if the surgical procedure includes instrumentation within the spinal canal. In 5 of the cases reported herein the cause for spinal cord injury was identifiable; in the remaining 5, the mechanism of injury is either obscure or not reported. All 10 patients reported had their surgery performed using the drill and dowel technique. The role of the posterior osteophyte in spondylosis and the rationale for routinely entering the spinal canal in order to decompress the spinal cord and nerve roots are examined. Since the majority of refractory disk problems that require surgery can be satisfactorily managed by discectomy and interbody fusion alone, routine instrumentation within the spinal canal may be an avoidable hazard in the majority of instances. The pathogenesis and prognosis of the anterior cord syndrome is reviewed, a possible etiology is suggested, and the anatomy, the autonomy and the importance of the anterior spinal artery system are noted. Its vulnerability in the treatment of degenerative disk disease and a possible mechanism for its occult impairment is mentioned.

Adult↗
PubMed1975

Biomechanical analysis of structural stability of internal fixation in fractures of the thoracolumbar spine.

Three different methods of internal fixation for the flexion-rotation thoracolumbar spinal fractures were tested biomechanically in a cadaver model for strength, mode of failure and ease of application. The compression rod system was clearly superior in strength and rotational stability to the spring device, but it was more difficult to apply than springs. The distraction rod system exhibited an intermediate level of strength with adequate rotational stability. Technically, the method is exacting and requires a clear understanding of its principle of 3 point fixation.

Biomechanical Phenomena↗
PubMed1975

The management of long bone fracture in the spinal cord injured patient.

Principles of management of long bone fractures in patients with spinal cord injuries vary with the type of fracture and duration of quadriplegia. Class I fractures (acute injuries) are managed by existing principles of long bone fracture management with a tendency to open reduction and internal fixation to dispense with the necessity of plaster casts on insensate skin. Class II fractures (pathologic--osteoporotic) heal well, require minimal specific treatment, and open reduction is usually contraindicated. Class III fractures (acute injuries in chronic paraplegia) are treated with methods least likely to disrupt the patient's life style in a wheelchair. Open reduction should be used whenever there are difficulties with circular casts and traction methods.

Arm Injuries↗
PubMed1975

Diagnosis and prognosis of acute cervical spinal cord injury.

The diagnosis of complete or incomplete quadriplegia and designation of functional levels can be accurately determined during the first 24 hours after injury in virtually all cases of severe traumatic quadriplegia. The prognosis for recovery depends upon an understanding of regeneration of nerve roots following injury and the significance of return of involuntary reflex activity. A realistic prognosis and accurate evaluation of various forms of treatment depend upon accurate documentation of the pattern of sensory and motor deficits.

Arm↗
PubMed1975

Heterotopic ossification around the hip joint in spinal cord injured patients.

Thirty patients with heterotopic ossification following spinal injuries were divided into acutely-injured and post-surgical groups. Patients in the acutely injured group had symptoms of heterotopic ossification within 6 months of injury. The formation and maturation of the heterotopic bone around the affected hip(s) were studied by serial alkaline phosphatase determinations and radiographic examinations. Radionuclide bone scans using 99m Technetium diphosphonate were made in all patients. Treatment consisted of maintaining range of motion. This appears to be a self-limiting process as maturation occurs. Surgery was not necessary in this group. In patients with mature deposits, wedge and segmental resection of the extraosseous bone was necessary to regain enough hip flexion for the patinets to sit. This was followed by vigorous joint ranging. After one year, average range of recovered flexion was 60 degrees.

Adult↗