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Biomedical subjects

F J Falco

Publications and source records attributed to F J Falco.

9 recordsLinked to original sources
PubMed1999

Three pathways between the sacroiliac joint and neural structures.

BACKGROUND AND PURPOSE: Despite ongoing clinical suspicion regarding the relationship between sacroiliac joint (SIJ) dysfunction and lower extremity symptoms, there is a paucity of scientific literature addressing this topic. The purpose of this study was to describe patterns of contrast extravasation during SIJ arthrography and postarthrography CT in patients with lower back pain and to determine whether there are pathways of communication between the SIJ and nearby neural structures. METHODS: Fluoroscopically guided SIJ arthrography was performed on 76 SIJs. After the injection of contrast medium, anteroposterior, lateral, and oblique radiographs as well as 5-mm contiguous axial and direct coronal CT images were obtained. Contrast extravasation patterns were recorded for each joint. These observations included a search for contrast extravasation from the SIJ that contacted nearby lumbosacral nerve roots or structures of the plexus. RESULTS: Sixty-one percent of all joints studied revealed one of five contrast extravasation patterns. Three of these observed patterns show a pathway of communication between the SIJ and nearby neural structures. These included posterior extravasation into the dorsal sacral foramina, superior recess extravasation at the sacral alar level to the fifth lumbar epiradicular sheath, and ventral extravasation to the lumbosacral plexus. CONCLUSION: Three pathways between the SIJ and neural structures exist.

Adult↗
PubMed1997

The Fortin finger test: an indicator of sacroiliac pain.

Simple and reliable diagnostic aids need to be available for clinicians to consider sacroiliac joint dysfunction in the differential diagnosis of low back pain. The Fortin finger test was used as a means to identify patients with low back pain and sacroiliac joint dysfunction. Provocation-positive sacroiliac joint injections were used to ratify or refute the applicability of this new clinical sign for identification of patients with sacroiliac joint dysfunction. Sixteen subjects were chosen from 54 consecutive patients by using the Fortin finger test. All 16 patients subsequently had provocation-positive joint injections validating sacroiliac joint abnormalities. A subset of 10 individuals underwent additional evaluation to exclude the possibility of confounding discogenic or posterior joint pain sources. All 10 patients had no indication of either discogenic or zygapophyseal joint pain generators. These results indicate that positive findings of the Fortin finger test, a simple diagnostic measure, successfully identifies patients with sacroiliac joint dysfunction.

Adult↗
PubMed1994

H reflex latency in the healthy elderly.

The purpose of this study was to evaluate prospectively and analyze the relationship of tibial nerve H reflex latency to age, sex, leg length, and skin temperature in a large healthy elderly population. The H reflex was recorded bilaterally in 92% of 103 carefully screened individuals aged 60-88 years. The mean H reflex latency was 30.8 (SD = 2.6) and 30.7 (SD = 2.6) ms for right and left legs, respectively. A high correlation (r = 0.55, P < 0.05) was present between H reflex latency and leg length. No significant correlation existed for H reflex latency and age. The upper normal limit for the difference between right and left H reflex latencies was 1.8 ms. This limit is greater than that reported in the literature for younger individuals due to a larger standard deviation. These findings suggest that aging increases the between-leg variability of H reflex latency in individuals. This greater difference must be taken into account when using side-to-side H reflex latency comparison to detect unilateral pathology in the elderly.

Aged↗
PubMed1994

Median and ulnar nerve conduction studies: normative data for young adults.

Temperature control and standardized technique, along with consideration of age, height, finger circumference, and instrumentation is imperative for appropriate interpretation of electrodiagnostic studies. Normative data must be based on these factors in adequate numbers of healthy subjects. This study provides comprehensive normative electrodiagnostic data for the median and ulnar nerves. Forty-four subjects participated in this study. The median motor studies showed a motor distal latency (DL) of 3.2 (0.4)msec, and distal amplitude (DAMP) of 12.1 (3.8)mV and sensory studies showed a DL of 2.5 (0.2)msec, and DAMP of 31.4 (8.7) microV for the men and 52.4 (14.3)microV for the women. The ulnar motor studies showed a motor DL of 2.6 (0.3)msec, and DAMP of 12.6 (2.3)mV and sensory studies showed a DL of 2.4 (0.2)msec, and DAMP of 27.0 (7.8)microV for the men and 52.9 (13.9)microV for the women. Sidedness and handedness did not affect the nerve conduction parameters of this study. Aging changes for these nerves were minimal but more apparent for the median nerve. The most noticeable change with aging was the decrease in amplitude of the sensory nerve action potential.

Action Potentials↗
PubMed1994

Gender and arm length: influence on nerve conduction parameters in the upper limb.

Median, ulnar, and radial nerve conduction studies (NCS) were performed in 44 subjects. Student's t-test was used to compare nerve conduction velocities (NCV), distal latencies (DL), and distal amplitudes (DAMP) for the two sexes. Only the sensory DAMPs showed statistical significance (p < .001) for gender. Women had greater mean median (52.4 microV vs 31.4 microV), ulnar (52.9 microV vs 27.0 microV), and radial (46.1 microV vs 20.1 microV) sensory DAMPs. Stepwise linear regression analysis of NCVs, DLs, and DAMPs on gender and arm length showed statistical significance only for the median (R2 = .46, p < .001), ulnar (R2 = .59, p < .001), and radial sensory DAMPs (R2 = .29, p < .001) for gender. Arm length did not account for any additional variability. Gender showed an effect on the distal sensory DAMPs obtained by antidromic technique in this study. In contrast to the reported effect of leg length and height on lower limb studies, arm length did not affect upper limb studies.

Adult↗
PubMed1994

Standardized nerve conduction studies in the lower limb of the healthy elderly.

Nerve conduction studies are commonly performed in elderly individuals. No complete set of reference data for the distal lower limb nerves exists for this population, making it difficult to accurately interpret electrodiagnostic findings. The purpose of this study was to provide reliable reference data by comprehensively examining conduction characteristics in routinely tested peripheral nerves of the lower limb in a healthy elderly population. Conduction studies of the tibial, deep peroneal, sural and medial dorsal cutaneous nerves were performed in one lower limb of 122 healthy elderly individuals between the ages of 60 and 89 years. Peak amplitudes of the sural sensory action potential and the tibial compound muscle action potential correlated significantly with both age and leg length. All other parameters did not show significant correlation with age. Conduction velocities and distal latencies slowed significantly with increasing leg length except for tibial distal latency.

Aged↗
PubMed1992

Standardized nerve conduction studies in the upper limb of the healthy elderly.

Nerve conduction studies are increasingly being performed on elderly individuals; however, no standardized data for the elderly population exists to provide an accurate interpretation of electrodiagnostic findings. The purpose of this study was to provide standardized data in the healthy elderly for the nerves of the upper limb that are routinely chosen for study by electromyographers. Nerve conduction studies were performed prospectively in one upper limb of 155 carefully screened healthy elderly individuals between the ages of 60 and 95 years. Upper limb temperature was controlled to limit the influence of temperature on the measured conduction parameters. Standard nerve conduction techniques using constant measured distances were applied to evaluate the median, ulnar and radial nerves. A normative electrodiagnostic database for elderly individuals was established in this study. The mean nerve conduction parameters of this healthy elderly population compared favorably with existing literature values for younger populations. However, age had a statistically significant but low strength effect on all ulnar nerve conduction velocities and distal latencies as well as the distal sensory amplitudes of all three nerves. Gender had a greater effect than age on these parameters as well as on median sensory distal latency. Other median motor and sensory conduction parameters along with radial sensory distal latency were not significantly related to age or gender based on two-way analysis of variance.

Aged↗
PubMedDate not supplied

Lumbar spine injection procedures in the management of low back pain.

Lumbar spine injections have a role in the evaluation and treatment of low back pain. These injection procedures have been demonstrated to be effective in determining whether certain structures are responsible for low back pain. There is still debate as to the long-term pain relief from epidural and intra-articular facet joint injections, and there are no controlled studies examining the long-term effects of SI joint injections. There is evidence to support that these injections give temporary relief of low back pain for months. This duration of pain relief creates an opportunity to maximize rehabilitation efforts while symptoms are minimal. There is a need for more controlled studies to evaluate the long-term effectiveness that these lumbar spine injections have on controlling low back pain. Future studies also need to assess in a controlled manner the impact that these injections have no rehabilitation and their role in functional restoration of lumbar spine disorders.

Glucocorticoids↗