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Biomedical subjects

J F Cusick

Publications and source records attributed to J F Cusick.

At least 19 recordsLinked to original sources
PubMed1992

The biomechanics of lumbar facetectomy under compression-flexion.

Alterations of posterior spinal elements including the facet joints are commonly associated with a variety of lumbar operative procedures. Under continuous physiologic compression-flexion load application L2-L3 and L4-L5 functional units were tested as intact preparations and then sequentially altered with unilateral facetectomy, bilateral facetectomy, posterior ligament transection, and partial discectomy. Using a method of continuous motion analysis, the movement of the individual spinal components (disc, facet joint, interspinous process distance) were statistically compared between the various surgical alterations. Higher physiologic loads produced significant increases in overall deflection from BF to BFL alterations indicating a preference to preserve the posterior ligaments for this surgical approach. Although insignificant changes in the force-deflection response from one surgical alteration to the next sequential alteration were noted, statistically significant increases in localized facet joint motion may suggest the potential for acceleration of segmental degenerative changes.

Aged↗
PubMed1992

Biomechanics of sequential posterior lumbar surgical alterations.

Compromise of the functional integrity of the posterior lumbar ligaments and facet joints is a common occurrence after repeated lumbar operative procedures. To evaluate the biomechanical effects of sequential surgical alterations, this investigation analyzed bilateral facetectomies (medial, total, and total with posterior ligament section) in three segments of human cadaveric lumbar spines under increasing compression-flexion. These iatrogenic alterations, designed to replicate common methods of surgical exposure, were created at the lower intervertebral joint (L4-5) while the upper joint (L3-4) remained intact. Overall strength characteristics in the physiological range of 400 N and 600 N demonstrated significant differences (p less than 0.05) in applied compressions for all preparations compared to the intact specimen. Comparison of sequential surgeries, however, did not demonstrate this tendency. Significant changes in the movement of the spinous processes at the upper (unaltered) level occurred only after posterior ligament section, whereas the lower (altered) level showed markedly increasing distraction of both the facets and the spinous processes with sequential operations. Sectioning of the supraspinous/interspinous ligament and associated fascial attachments resulted in a marked transfer of motion to the altered level. This was manifested by the increased anterior displacement of the centrode at the lower level associated with probable posterior migration of the centrode at the upper level. These data suggest that the effects of progressive surgical alterations of the lumbar facet joints are controllable in a preparation undergoing acute compression-flexion loads until the supraspinous/interspinous ligaments, with associated residual tendinous, midline muscle, and fascial attachments, are violated.

Aged↗
PubMed1991

Pathophysiology and treatment of cervical spondylotic myelopathy.

Operative procedures on the cervical vertebral column and spinal cord must be designed selectively for the individual patient. The majority of present series suggest that the anterior approach, especially vertebrectomy, may be associated with the highest levels of clinical improvement, but posterior approaches present significant advantages in treating the patient with multilevel disease (three or more levels). Laminectomy, however, must be avoided in the presence of straightening or curvature reversal of the cervical vertebral column. In certain select cases, consideration of a combined anterior and posterior approach or total stabilization may be considered. Although no consensus exists regarding the exclusivity of a specific surgical procedure and all possible approaches should be considered, the final decision should be based on detailed biomechanical considerations. Complete radiographic and neurophysiologic studies, including evaluation in various dynamic positions of the cervical spine (flexion, extension, and rotation), are of assistance in defining the most efficacious treatment method.

Cervical Vertebrae↗
PubMed1990

Injury biomechanics of the human cervical column.

In this study, the authors have developed a technique to replicate clinically relevant traumatic cervical spine injuries and determined the injury biomechanics. Because of the importance of compressive forces in neck injuries, this research was conducted using compression as the primary load vector. Six fresh human cadaveric head-neck complexes were prepared by fixing the distal end in methylmethacrylate. Tests were done with varying loading rates to include quasistatic and dynamic conditions. For quasistatic experiments, the proximal end was fixed to the piston of the testing device. In dynamic tests, the cranium was unconstrained, and to maintain stability, the effects of the spinal musculature were simulated by means of pulleys, deadweights, and springs in the anterior and posterior parts of the head-neck complex. Quasistatic tests conducted at a rate of 2.0 mm/sec produced cervical spine trauma at forces ranging from 1.7 to 2.3 kN, with deformations ranging from 2.2 to 3.7 cm. The specimens were deep-frozen at the level of injury, preserving the local deformation of the tissues to enable a detailed evaluation immediately after the injury. Dynamic tests conducted at velocities of 3.2 to 5.7 m/sec resulted in impact injuries at one level of the head-neck complex. The applied forces at the vertex were considerably higher than those recorded at the distal end. The failure deformations for both the quasistatic (2.2-3.7 cm) and dynamic (1.7-3.2 cm) tests, however, were found to be similar, suggesting that the human head-neck complex is a deformation-sensitive structure.

Aged↗
PubMed1989

Neurosurgical considerations of cervical myelopathy.

Operative procedures on the cervical vertebral column and spinal cord must be selectively designed for the individual patient. Complete radiographic and neurophysiologic studies, including evaluation in various dynamic positions of the cervical spine (flexion, extension, and rotation), are necessary to define the most efficacious treatment method. No consensus exists regarding the exclusivity of a specific surgical procedure and all possible approaches should be considered, with the final decision based on detailed biomechanical considerations.

Cervical Vertebrae↗
PubMed1986

Comparison of single-photon emission computed tomography with [123I]iodoamphetamine and xenon-enhanced computed tomography for assessing regional cerebral blood flow.

Regional CBF (rCBF) images obtained from xenon-enhanced computed tomography (XeCT) and single-photon emission computed tomography (SPECT) with N-isopropyl-p-[123I]iodoamphetamine (IMP) done with a rotating gamma-camera were compared in nine patients. Both XeCT and SPECT/IMP demonstrated flow abnormalities at all sites of infarction identified by CT, while detecting reduced rCBF in areas normal by CT in eight of the nine patients. All areas that were abnormal on XeCT were abnormal on the comparable SPECT/IMP images. The major advantages of XeCT are its greater resolution and potential for noninvasive quantitation of rCBF, while the major advantage of SPECT/IMP is its visualization of the entire brain on transverse, coronal, and sagittal sections.

Amphetamines↗
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↗
PubMed1979

The computed tomographic appearance of the normal pituitary gland and pituitary microadenomas.

With the use of axial and coronal computed tomography (CT), the authors compared the density, contrast enhancement, and dimensions of normal pituitary glands and pituitary microadenomas. The normal gland appears homogeneous, nearly isodense with brain tissue, and it enhances uniformly. Its upper surface is concave downward or flat and its height 2-7 mm. The cavernous sinuses, the third, fourth, and sixth cranial nerves, the infundibulum, and the adjacent carotid arteries are well demonstrated by CT. Abnormal height and upward convexity of the gland are reliable signs of prolactinoma; abnormal density and enhancement are suggestive signs. CT findings in prolactin- and ACTH-secreting tumors may differ. CT is more sensitive and more specific than polytomography in the diagnosis of pituitary adenoma.

Adenoma↗
PubMed1978

Ultrastructural identification of afferent fibers of cardiac origin in thoracic sympathetic nerves in the dog.

While cardiac afferent nerve activity has been recorded from the ventrolateral (VLCN) and ventromedial (VMCN) cardiac nerves, left dorsal and ventral ansae subclaviae, and left upper thoracic white rami communicantes, little anatomical evidence for the existence of afferent fibers in these nerves has been reported. This study was designed to characterize the normal ultrastructure of the above nerves and to identify afferent fibers in them through Wallerian degeneration produced by dorsal root ganglionectomy. Laminectomies followed by dorsal root ganglionectomies were performed on left thoracic roots T1-T4 in six mongrel dogs. The nerves to be examined were removed from two animals at 1, 2, and 3 weeks following ganglionectomy and prepared for electron microscopy. Control nerves were obtained from two normal dogs. Degenerating nonmyelinated fibers were characterized by watery axoplasm containing clumps of electron-dense material. Degenerating myelinated fibers were distinguished by the separation of their myelin lamellae, producing characteristic whorls. After three weeks, afferent nonmyelinated axons had degenerated in all nerves, leaving only layered processes of Schwann cells in these areas. Approximately 5-15% of the fibers in each nerve degenerated, indicating their afferent nature. Of these fibers, 85-90% were nonmyelinated C fibers and the remainder myelinated Adelta fibers. These results indicate participation of both Adelta fibers and a large population of C fibers in transmission of cardiac afferent activity.

Animals↗
PubMed1978

Early somatosensory evoked potentials.

The early somatosensory evoked potential secondary to median nerve stimulation in the human had an onset latency of 9--12 msec when recorded from scalp electrodes at vertex-to-mastoid, vertex-to-inion or at the base of the skull. Similar latencies were observed from responses recorded over the cervical dorsal columns during neurologic surgery. A latency difference of 1.5 msec was observed between the early response and the responses recorded from the junction of medial lemniscus and nucleus ventralis posterior lateralis of the thalamus during human stereotaxic surgery. Cervical cord transections and transection at the midpontine levels of the monkey showed that the evoked potential was due to generators between these levels. Depth recording of the monkey indicate that the early evoked potential originates in the region of dorsal column nuclei, while the later components are secondary to generators in cerebral cortex.

Animals↗
PubMed1978

A myelographic technique for cysts in the spinal canal and spinal cord.

A collapsing cord in six patients with hydromyelia and a collapsing intraspinal arachnoid cyst in one patient are demonstrated. The authors describe the technique for two-position gas myelography and demonstrate that both intra- and extra-medullary intraspinal processes may collapse during myelography.

Adolescent↗
PubMed1978

Spinal evoked potentials in the primate: neural substrate.

Summated responses evoked by peripheral nerve stimulation were recorded from electrodes located in the epidural and subdural spaces anterior and posterior to the monkey spinal cord. Segmental microsurgical resection of the dorsal columns both at the thoracic and cervical levels resulted in total obliteration of the response recorded rostral to these lesions. Isolated segmental dorsal column preservation did not significantly alter response latency or wave form recorded at the rostral electrodes. Bilateral cervical dorsolateral column resection also resulted in no discernible alterations of these responses. These data indicate that spinal evoked potentials recorded from levels rostral to their root entry zones arise almost exclusively from the dorsal columns.

Animals↗
PubMed1977

Ventral root mapping of cardiac nerves in the canine using evoked potentials.

The sympathetic efferent contribution of left ventral roots T2, T3, and T4 to some cardiac nerves was studied using evoked potentials in mongrel dogs anesthetized with sodium pentobarbital. Electrical stimulation of the ventral roots while recording evoked potentials from the sympathetic chain, anterior ansa subclavia, posterior ansa, ventrolateral cervical cardiac nerve, ventromedial cervical cardiac nerve, and the vagosympathetic trunk demonstrated that A-, B-, and C-type fibers exist in these efferent neural pathways. The range of conduction velocities observed was 0.7-104 m/s. T2 contributed the largest number of A-type fibers, and T2 and T3 contributed C-type fibers equally, while T4 had the least number of fibers coursing through the cardiac nerves.

Animals↗
PubMed1977

Mechanical and physiological effects of dentatotomy.

The role of the dentate ligaments in the pathogenesis of myelopathy secondary to disease conditions that alter the normal biomechanics of the spinal canal was studied in 14 dogs. The effects of posterior cord elevation on somatosensory evoked potentials (SSEP's) and tension requirements were compared before and after dentate ligaments section in acute experiments. At levels of posterior elevation usually within the confines of the canine canal, the dentate ligaments were the most significant element increasing tension requirements and SSEP alternations. Human cadaver studies also showed an approximate 50% reduction of force after dentatotomy. These findings suggests that after dentate ligaments section the applied tension is distributed over a longer segments of the cord with a reduction in tension and disruption of axonal conduction at the level at which the force was applied.

Animals↗