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Biomedical subjects

J B Myklebust

Publications and source records attributed to J B Myklebust.

36 records · Page 2Linked to original sources
PubMed1986

Enhancement of voluntary motor function following spinal cord stimulation--case study.

One patient with an incomplete traumatic myelopathy underwent epidural spinal cord stimulation for the management of severe intractable spasms, which were abolished by the stimulation. After several months of stimulation, the patient regained some voluntary motor function in the lower extremities. Voluntary motor control of the left quadriceps was present only when spinal cord stimulation was activated and stopped immediately after it was turned off. The effects could be consistently reproduced. EMG polygraphic recordings confirmed the results.

Adult↗
PubMed1985

Comparison of the failure biomechanics of spinal fixation devices.

The failure biomechanics of Harrington distraction rods, modified Weiss springs, and Luque rods were studied in intact cadavers and isolated spinal columns using flexion-compression loading. Most spines fractured at T-11 or T-12 at applied loads ranging between 556 and 4220 newtons (mean = 1833 N). After Harrington distraction rod placement, the same spines failed at a mean load of 859 N (42% of control), always as a result of hook extrusion and often including lamina fracture (seven cases). When modified Weiss springs were used, the spines failed at a mean load of 1128 N (54% of control) by allowing the spine to bend to the initial failure angle; in most instances, deformities resolved when the load was reduced. Luque rods were tested in four specimens; these provided the most rigid stabilization and failed at 83% of control values. Modified Weiss springs often maintain spinal stability better than Harrington distraction rods.

Aged↗
PubMed1985

Immediate effects of spinal cord stimulation in spinal spasticity.

Six patients with intractable spasms after spinal cord injury underwent implantation of an epidural spinal cord stimulation system. All the patients experienced good relief postoperatively. In three patients spinal cord stimulation consistently produced immediate inhibition of the spasms. This was evident within less than 1 minute of stimulation. Conversely, the spasms reappeared within less than 1 minute after cessation of the stimulation. The clinical observations were confirmed by polygraphic electromyographic recordings.

Adult↗
PubMed1984

Electrophysiological effects of lumbar dorsal root stimulation.

Electrical stimulation was applied to the L-5 and L-6 dorsal root ganglia of 14 monkeys with concurrent monitoring of cortical and intralaminar thalamic evoked potentials. Both responses were decreased by root stimulation, although cortical suppression required current levels 50 to 100% higher. The evoked potentials remained suppressed for periods of up to 60 minutes after 10- to 15-minute stimulation of the lumbar root electrodes. There was no increase in the duration of transmission block with longer stimulation periods. These results and available clinical data suggest that a local conduction block may be responsible for the pain relief produced by peripheral electrical stimulation. Further studies to identify more precisely the neural systems affected are required.

Afferent Pathways↗
PubMed1984

The biomechanics of spinal injuries.

This manuscript is directed to review the epidemiology of spinal trauma, the anatomy of the vertebral column, spinal ligaments, muscles, motion of the spine and spinal cord. Because little information is available on the material properties of ligaments and the components of the vertebral column, this material is also included. A review of the experimental spinal cord injury models is given because of the concerted interest in this area today. Laboratory studies conducted in animals to develop typical spinal cord injury models and the corresponding alterations in perfusion and metabolic pathways, forces, and changes in the evoked potentials are discussed. Light and electron microscopy evaluations of the spinal cord are also treated. Clinical classifications of spinal injuries, pathology, and typical examples of upper cervical injuries, atlanto-axial disc locations and fractures, lower cervical spine injuries, injuries to thoracolumbar column with mathematical models, and typical force levels are given. The final section, investigation examples, provides a review of typical spinal injuries associated with sports injuries, motorcycle helmets, industrial helmets, and swimming pools investigated in our laboratories and by those of others. With lumped parameter mathematical model which predicts cervical compression, force, the various energies encountered in a one-dimensional impact is given. Typical examples of studies conducted on football helmets, motorcycle helmets, and industrial helmets are also included. Because of the importance of crash dummies used in the analysis of spinal injuries, a separate appendix is included, as well as an appendix reviewing motorcycle standards which are often dispersed throughout the literature. Considerable emphasis is placed upon actual experimental values of force and energy measured in the living animal and the most recent studies conducted in the fresh human cadaver to delineate the biomechanical mechanisms of spinal injury.

Accidents, Traffic↗
PubMed1983

Compression injuries of the cervical spine: a biomechanical analysis.

Three intact cadavers and 10 isolated cervical spinal columns underwent compression, with forces directed vertically, forward, or rearward. Failure modes were often different than force directions. The loads required to produce bony injury or ligamentous disruption ranged from 645 to 7439 N. Flexion and extension injuries were produced at approximately 50% of the loads required for axial compression failures. The direction of force delivery correlated only partially with the resulting pathological condition. Clinical decisions based on retrospective analysis of roentgenograms may not account for the variability of forces and the prominence of ligament injuries seen in spinal trauma. Some of the difficulties encountered in biomechanical analyses of spinal trauma are discussed.

Accidents, Traffic↗
PubMed1982

Altered neural conduction with epidural bupivacaine.

The sites and magnitude of evoked potential response alterations induced by varying masses and concentrations of epidurally administered bupivacaine were assessed from electrodes positioned along the conducting pathways of the monkey. The mass of bupivacaine was the major factor in determining the level and degree of response alterations. At the lower levels of total drug mass, effects were limited to the dorsal root entry zone, whereas higher levels of mass not only increased the response attenuation at the gray matter level but resulted in additional changes in those responses recorded from the spinal cord white matter tracts. With all other factors stable, increasing concentration was associated with a greater degree of response attenuation, especially at the lower levels of total mass. These findings indicate that the mass of the drug is the major factor in determining the magnitude and level of bupivacaine-induced epidural analgesia. Increased concentration influences the local anesthetic's penetration at the dorsal root entry zone and, to a lesser degree, at the white tracts of the spinal cord.

Anesthesia, Epidural↗
PubMed1981

Experimental electrical injury studies.

Voltages from 10 to 14,000 volts demonstrated currents up to 70 amperes with resistances of approximately 200 ohms in studies in hogs. Below 1,000 volts, a current reduction is observed following arcing and skin necrosis. At the higher voltages, this phenomenon was not observed. The energy required for tissue damage was dependent upon the voltage and time of application. The tissue electrode resistance with stainless steel disc was proportional to the diameter. Skin buring commenced at the periphery of the electrodes and moved inwards. For application of currents between the hindlimbs of the hog, the current per tissue cross-section was greatest in artery and nerve, followed by muscle, fat, bone marrow, and bone cortex.

Animals↗
PubMed1980

Differential neural effects of epidural anesthetics.

The purpose of this investigation was to clarify in a laboratory model the sites of action of epidurally administered local anesthetics. This report describes such a a model, which is capable of monitoring sites of altered electrophysiologic activity induced by epidural anesthetic agents. Evoked potential response alterations measured from electrodes positioned along the conducting pathways were assessed in six monkeys following epidural injections of 0.5 per cent bupivacaine, 3 per cent chloroprocaine, and 1 per cent etidocaine. Bupivacaine in ten studies was found to cause its major effects at the dorsal root entry zone and the long tracts of the spinal cord white matter, associated with variable peripheral nerve alterations. Chloroprocaine effects in six studies were limited to alteration of responses recorded from the dorsal root zone and peripheral nerve. In contrast, etidocaine in eight studies caused marked attenuation of the responses recorded from the long tracts of the spinal cord white matter, associated with only minimal corresponding changes at the dorsal entry zone or peripheral nerve levels. These findings illustrate the capability of this experimental model to demonstrate relatively selective effects along the sensory and motor pathways for epidurally injected local anesthetic agents.

Anesthesia, Epidural↗
PubMed1979

Spinal cord evaluation by cortical evoked responses.

In ten monkeys, selective segmental lesions of the dorsal columns at the upper thoracic and middle cervical levels resulted in almost total attenuation of the cortical evoked potential responses to peripheral nerve stimulation. Conversely isolated segmental dorsal column preservation showed intact transmission of the evoked responses at rostral spinal cord, nucleus ventralis posterior lateralis, and cortical levels. Responses recorded from the intralaminar thalamic nuclei in the region of nucleus centrum medianum were unaffected by dorsal column ablation, but were markedly attenuated following bilateral ventral column ablation.

Animals↗
PubMedDate not supplied

Evaluation of nonlinear dynamics in postural steadiness time series.

Fractal and correlation dimensions have been computed for time series obtained from tests of balance (postural steadiness). Although these measures appear to be reliable and differentiate subject groups, it has become clear that random (noise) time series may have finite dimensions and appear to demonstrate dynamics characteristic of nonlinear systems. Consequently, it is necessary to apply a test to distinguish a time series with putative nonlinear dynamics from random noise. A simple predictor was utilized to compare center of pressure (COP) time series with surrogate data constructed to have similar time and frequency domain characteristics. It was found that the original time series was more predictable than the surrogate data, suggesting that the COP data is derived from a nonlinear system.

Adult↗
PubMedDate not supplied

Approximate minimum bias multichannel spectral estimation for heart rate variability.

Spectral decomposition of variations in heart rate permits noninvasive measurement of autonomic nervous activity in humans and animals. Autonomic metrics based on spectral analysis are useful in monitoring clinical conditions such as diabetic neuropathy and reinnervation in heart transplant patients. A persistent problem in deriving such autonomic measures is the prerequisite of an accurate and unbiased power spectrum of heart rate variability (HRV). Numerous parametric and nonparametric power spectrum estimators have been introduced, each with its own advantages and drawbacks. Estimator bias has received little attention, despite the fact that at least one common HRV spectrum estimator, the autoregressive method, is known to exhibit bias even in idealized circumstances. We introduce an approximately minimum bias, nonparametric, multichannel spectrum estimation procedure for HRV and contemporaneous signals. The procedure, which is designed specifically for irregular sampling, does not require data segmentation and provides statistically consistent, low variance multichannel spectrum estimates. Estimator performance on simulated and clinical data is presented and compared with results from autoregressive models and Welch periodograms with and without compensation for irregular sampling. Results indicate that the proposed method exhibits advantages over conventional HRV spectrum estimators. Relative computational complexity of the proposed method is also considered.

Adult↗