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Biomedical subjects

H Alaranta

Publications and source records attributed to H Alaranta.

At least 73 records · Page 4Linked to original sources
PubMed1993

Spondylodesis augmented by transpedicular fixation in the treatment of olisthetic and degenerative conditions of the lumbar spine.

Fifty-one patients having lumbar or lumbosacral posterolateral fusion with pedicle screw internal fixation were reviewed retrospectively two years after the fusion by an independent observer. In 44 patients, the underlying condition was lytic or degenerative spondylolisthesis. The internal device was removed one year after the fusion. The fusion rate was 94%. The subjective disability was assessed using the Oswestry disability index. The mean Oswestry score was 38% preoperatively, and 24% two years after the fusion. Preoperatively, only every fifth patient was able to work; two years postoperatively, almost 60% held jobs. Complications due to internal fixation were recorded in 57% of the cases. Most of these, such as screw breakage and screw loosening in the sacrum, were of no clinical importance. The use of internal fixation seems to enhance the fusion rate but is associated with more complications than posterolateral fusion without implants.

Adult↗
PubMed1993

Lower-limb amputations.

The current epidemiological situation with regard to lower-limb amputations in southern Finland was analysed for the year 1989. Lower-limb amputations were performed on 268 patients. The amputation rate was 22.0 per 100,000 inhabitants, and the mean age of amputees was 70 years. Peripheral vascular disease was the main reason for amputation (79%). The most common level of amputation was above-knee (49%) followed by below-knee (29%). Two thirds (64%) of the patients lived over one year, and half (53%) over two years after the amputation. In the group of patients undergoing unilateral amputation and surviving over two months, 26% of the above-knee and 63% of the below-knee amputation patients received a prosthesis. The (average) time lag between surgery and fitting the prosthesis was 97 days. Incidence and mortality were decreased after 1985. The rate of prosthesis fitting was still low but the time lag between surgery and prosthetic fitting had decreased.

Adult↗
PubMed1993

Fat content of lumbar extensor muscles and low back disability: a radiographic and clinical comparison.

The fat content of the lumbar back extensor muscles was assessed from computed tomograms and correlated to self-reported disability in 39 consecutive chronic low back pain patients. The assessment for the quality of fat was done separately for the three lowest lumbar intervertebral levels. The Oswestry index was used to evaluate the low back disability. Analysis showed positive relationship between the fat content of the lumbar paraspinal muscles at lumbosacral level and self-reported disability in men. The relationship was weaker in women, and at higher lumbar levels it was not found in either sex.

Adipose Tissue↗
PubMed1992

Calcitonin treatment in lumbar spinal stenosis: a randomized, placebo-controlled, double-blind, cross-over study with one-year follow-up.

A randomized, placebo-controlled, double-blind, crossover study in 40 lumbar spinal stenosis patients with a 1-year follow-up showed that calcitonin had beneficial effects on the patients' symptoms without producing any notable side effects. Calcitonin had a clear analgesic effect. The mean of walking distance increased, but the crossover trend was not as good as the analgesic effect. Side effects such as erythema and nausea were usually mild and transient. Calcitonin therapy can be used as a conservative treatment in selected cases of lumbar spinal stenosis. When rest pain was mild or the walking distance was under 200-300 m because of neurogenic claudication, the effect of calcitonin seemed to be poor.

Adult↗
PubMed1992

Lumbar mobility in asymptomatic individuals.

A radiological study of angulatory and translational lumbar mobility and of lumbar scoliosis was performed on 56 persons aged 35-54 years who had no history of back pain. The measurements of mobility were based on extension-flexion views; the assessment of scoliosis was done using radiographs taken in the standing position. The results indicated that the largest range of angulatory motion occurred in the L5-S1 segment (mean, 17.3 degrees for women and 16.4 degrees for men). Five-millimeter translational motion was so common in the L3-L4 and L4-L5 segments, as was 4-mm in the L5-S1 segments, that these values cannot be considered with certainty as pathological. Ten subjects (18%) showed scoliosis of > or = 10 degrees. Although based on a small series, these results are a step toward a more objective and careful interpretation of extension-flexion and functional radiographs of low-back pain patients.

Adult↗
PubMed1991

Clinical findings as outcome predictors in rehabilitation of patients with sciatica.

In rehabilitation of patients with sciatica, factors prognostic of long-term outcome could prove beneficial in interventions and in evaluating progress toward fitness or capacity for work. In this study results of physical examinations, carried out one year after hospital treatment for suspected lumbar intervertebral disc herniation, were related to outcome after five-years, as assessed by the categorization of occupational handicap of the International Classification of Impairments, Disabilities and Handicaps (ICIDH). The sample consisted of 276 patients admitted to hospital in the years 1980-1982. Based on established clinical indications 179 patients underwent lumbar disc surgery and the remaining 97 received further conservative treatment. One year after hospitalization a physician and physiotherapist examined the patients at the Rehabilitation Research Centre (RRC) of the Social Insurance Institution in Finland. In 1986 the patients returned to the RRC for further evaluation of their occupational handicap at that time. Stepwise logistic regression analysis showed that sensory deficits of legs, tenderness in lumbar extension, decreased repetitive trunk flexion performance (sit-up test), decreased lumbar lordosis and tightness of hamstrings were indicative of a poor outcome in the operated group. For the non-operated patients no statistically acceptable regression analysis model could be established.

Adult↗
PubMed1991

Leg-length inequality in people of working age. The association between mild inequality and low-back pain is questionable.

Leg-length inequality was measured from radiographs at the level of the vertices of the femoral heads in 247 men and women aged 35-54 years. Of these, 53 had never had any low-back problem, but they had considerable variation in leg-length inequality (mean SD, 5.5 +/- 4.1 mm; range, up to 20 mm). This group of symptom-free individuals did not differ from a group of 78 persons who had disabling low-back pain (LBP) during the previous 12 months (mean SD, 5.3 +/- 4.0 mm; range, up to 17 mm). The adjusted relative risks (odds ratios) of having LBP ever and of disabling pain during the last 12 months were 0.78 (95% confidence interval, 0.43-1.17) and 1.02 (0.68-1.38), respectively, for an increase of 5 mm in leg-length inequality. The results from this study make an association between mild leg-length inequality and LBP questionable.

Adult↗
PubMed1991

Social factors and outcome in a five-year follow-up study of 276 patients with sciatica.

Social factors of 179 operated and 97 non-operated patients one year after hospitalization due to low back pain and sciatica were tested by multi-variate regression analysis in relation to the five-year outcome evaluated according to the WHO Handicap Classification. For operated men a subjective working incapacity (relative risk RR = 4.6) and co-morbidity (RR = 2.7) predicted a poor outcome. For operated women the predictive factors were subjective working incapacity (RR = 3.2) and older age (RR = 1.9). For non-operated men an increased occurrence of occupational hazards (RR = 3.6) and for non-operated women co-morbidity (RR = 7.1) indicated a poor outcome.

Adult↗
PubMed1991

CT five years after myelographic diagnosis of lumbar disk herniation.

Fifty-seven patients were examined with CT 5 years after primary myelography for disabling sciatica and suspected herniated lumbar disk. Forty were in an operated group, 22 with good and 18 with poor results evaluated by occupational handicap (21) 5 years after surgery. Seventeen patients had myelography indicating disk herniation, but were treated conservatively, 9 with good and 8 with poor result. Various spinal dimensions measured at CT did not correlate with outcome. Operated patients had narrower canals than others, and male canals were broader than those in females. Increased amount of scar tissue at L4 level correlated with poor result (p = 0.008). Operated patients with poor result had more advanced lateral stenosis than those treated conservatively (p less than 0.001). Patients with good result after operation had more degeneration observed on CT of erector spinae muscle than those treated conservatively with good outcome. Only 9% of operated patients did not have muscle degeneration. A tendency for more frequent recurrent disk herniations could be seen for conservatively treated patients. The narrowing of the spinal canal 5 years after operation did not correlate with the 5-year outcome.

Adult↗
PubMed1991

Predictive factors of functional ability after lower-limb amputation.

Functional ability and accommodation situation were studied by personal interview and examination of 125 surviving lower-limb amputees after one postoperative year. Among ten independent variables studied by multiple linear regression analysis, an unfavourable association was found between increasing age and the following aspects of physical function: walking distance (P less than 0.001), walking time (P less than 0.001), amount of outdoor walking outdoors (P less than 0.001), increased need for aids to ambulation (P less than 0.01), use of a prosthesis (P less than 0.05). Using a partial correlation coefficient analysis of functional ability and accommodation situation, with adjustment for age, the time lag between surgery and prosthetic fitting, and the occurrence of cerebrovascular disease displayed a similar unfavourable association with prosthetic usage. In the group of BK (below-knee) amputees the length of the stump had a significant favourable relationship with walking distance (P less than 0.01). In the male group of vascular BK amputees, smoking had an unfavourable association with walking distance (P less than 0.01), ability to walk outdoors (P less than 0.01) and walking time (P less than 0.05). None of the variables showed any significant relationship with the postoperative accommodation situation.

Adolescent↗
PubMed1990

Severe frostbite of the upper extremities--a psychosocial problem mostly associated with alcohol abuse.

In the catchment area of Helsinki University Central Hospital (in total 16 surgical hospitals) amputation was performed on 9 patients with frostbite in the upper extremities during 1984-1985. The population during the study period in this area was 1.165,000 inhabitants, corresponding to 24% of the whole population in Finland. All 9 patients were male and the mean age was 49 years (range 31-75). All amputations performed were of the fingers, the third, fourth and fifth fingers most frequently affected. Alcohol was a marked etiologic or contributing factor in most of the frostbites. Two patients were chronic schizophrenics showing no signs of alcohol abuse, but the remaining 7 were either acutely or chronically alcohol intoxicated: 5 patients were chronic alcoholics, one was an alcohol abuser without a definite diagnosis of alcoholism, and one patient with no previous history of alcohol abuse was alcohol intoxicated. Based on the present study it is clear that, in addition to the cold winters in Finland, other factors contribute to severe frostbite. These include many psychosocial factors such as alcoholism or mental disease, unbalanced marital status, occupation handicap and lack of regular residence.

Adult↗
PubMed1990

Prosthetic use and functional and social outcome following major lower limb amputation.

A total of 175 consecutive below and above-knee amputees sent to the prosthetic workshop in Helsinki for prosthetic fitting from 32 hospitals were reviewed to determine their functional ambulation and social adaptation. The average age of the patients was 62.2 years at the time of the prosthetic fitting. The mortality was 11% (19) during the first postoperative year. One-year postoperative information was obtained for 141 of the surviving patients (90%) by personal contact. At the time of the review, 68% of the amputees (96 patients) who had been fitted with a prosthesis made extensive and regular use of it. Half of all the above-knee amputees and 79% of the below-knee amputees used their prosthesis throughout the day or over seven hours a day. A total of 72% of the above-knee amputees (33/46) and 85% of the below-knee amputees (67/79) had useful ambulation, at least indoors. Of the 141 patients contacted, 124 (88%) lived in their own homes. The remaining 16 patients (11%) lived in apartment houses for the aged or old people's homes. A total of 48 amputees (34%) needed a regular home help.

Adolescent↗
PubMed1990

A prospective study of patients with sciatica. A comparison between conservatively treated patients and patients who have undergone operation, Part I: Patient characteristics and differences between groups.

Based on a prospective study on 342 sciatica patients examined with rhizography, the aim was to determine which factors others than the rhizography finding and the grade and duration of symptoms were related to the selection of patients to undergo operation. Compared with surgically treated patients, conservatively treated patients who did not undergo operation and who had pathologic rhizography findings had pessimistic attitudes to possible surgery, often expressed a desire to retire, and considered their work as physically stressful. The women in this group were older and had lower pain indices than women who underwent operation. Conservatively treated patients with negative rhizography had more severe occupational handicaps, minor expectations of possible surgery, physically more strenuous jobs requiring difficult physical positions, and lower indices for pain and ADL than did the operated patients. The social and ergonomic background problems are emphasized in sciatica patients conservatively treated after rhizography.

Adult↗
PubMed1990

A prospective study of patients with sciatica. A comparison between conservatively treated patients and patients who have undergone operation, Part II: Results after one year follow-up.

The prospective study included 122 sciatica patients who had not undergone operation (NOPs) and 220 sciatica patients who had undergone operation (OPs); all had been examined by rhizography. The follow-up study was done on 110 (90%) of the NOPs and 212 (96%) of the OPs. The NOPs were divided into two groups: 30 patients with pathologic rhizography (PR) and 80 patients with negative rhizography (NR). Pain-, ADL-, and occupation-handicap indices showed that after the 1 year follow-up the OP group had the best result and the NR group the lowest result. The PR group had nearly as good a result as the OP group. Thus, sciatica patients are candidates for conservative therapy, even though they have pathologic findings in rhizography, if the symptoms are mild. To improve therapeutic outcome, more accurate diagnostic tools are needed to develop specific therapy especially for those sciatica patients with negative rhizography.

Adult↗
PubMed1990

Motor ability and personality with reference to soccer injuries.

Thirty-seven male soccer players performed a series of motor ability tests and answered the Sixteen Personality Factor Questionnaire (the 16PF). A past-injury examination and interview was performed by a physician and occurrence of injuries was followed up prospectively for one year. Stepwise regression analyses revealed significant associations between past injuries and long reaction time as well as personality factors N (astute) and H (shy). We conclude that both weakness of motor abilities, especially long reaction time, and a specific personality type may predispose a player to soccer injuries.

Adolescent↗
PubMed1989

Calcitonin treatment in lumbar spinal stenosis: clinical observations.

The prognosis of patients with lumbar spinal stenosis is usually considered poor, and they often need decompression surgery. This study investigates the clinical efficacy and safety of intramuscular calcitonin therapy in 15 lumbar spinal stenosis patients with a neurogenic claudication syndrome. The study is based on several tests used to measure the patient's physical performance capacity. Calcitonin had some beneficial effects on the patients without appreciable side-effects. Because of possible placebo effect, a double-blind cross-over study has been started.

Adult↗