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Biomedical subjects

J Kiwerski

Publications and source records attributed to J Kiwerski.

At least 19 recordsLinked to original sources
PubMed2000

Three methods for investigating, assessing and supporting the normal and pathological gait and manipulation activity.

Three methods to describe biped locomotion as well as manipulation activity are presented. Methods using so-called couple oscillators as rhythm generators are described. Based on a mathematical model, results of computer simulation of biped locomotion are presented. An indices method of assessing human gait for both normal and pathological cases was proposed and tested. The results showed that it is relatively easy to distinguish different gaits by using this method. This method was tested in clinical conditions. The third method deals with the problem of supporting the lost function of prehension movements. Implanted stimulators on the nerves combined with external orthoses were used. The clinical results show that these methods have practical advantages.

Computer Simulation↗
PubMed1996

[Factors determining results of surgical treatment for lumbar spine pain syndromes].

A series of 613 patients operated on because of lumbar spine pain syndromes with minimum follow-up of 6 months has been reviewed. Results accomplished were related to symptoms, neurological deficits, age of the patient at surgery, surgical approach, changes found intraoperatively, spine stability and type of stabilization. The degree of neurological deficit, duration of acute phase of the disease, changes found at surgery and spine stability influenced final result most.

Adult↗
PubMed1993

Hyperextension-dislocation injuries of the cervical spine.

Between 1965 and 1991, 132 patients with vertebral dislocation following hyperextension injury of the cervical spine were treated at the Spinal Injury Department of the Metropolitan Rehabilitation Centre in Konstancin, Poland. The series accounted for over 25 per cent of patients with hyperextension injuries and for about 7 per cent of all cervical-spine-injured patients treated during these years. These changes are most commonly found in two situations: (1) Injuries of the upper cervical spine. (2) Injuries sustained by individuals with advanced pathological changes in the spine. Such conditions are found in advanced spondylosis and ankylosing spondylitis. Such changes were noted in nearly 65 per cent of the patients in the series analysed. The improved results seen in surgically treated patients encourage the wider application of surgery in such groups of patients.

Accidental Falls↗
PubMed1993

[Trauma related changes of the cervical spine and spinal cord in myelography and MRI images].

Myelographic and MRI results in fourteen patients treated in 1992 because of cervical spine injury with neurological complications have been presented. Myelography proves to be useful in posttraumatic spine diagnostics but in some cases does not render sufficient information, especially if the trauma superimposes previously existing pathological changes. MRI is exceptionally valuable diagnostic modality in cervical spine injuries offering an advantage of both early and late evaluation of the post-traumatic spinal cord changes.

Adolescent↗
PubMed1993

[Post-traumatic epidural and subdural hematomas of the spinal cord in MR imaging].

Diagnostics of epi- and subdural haematomas of the spinal cord is discussed on the basis of 1992 records of Konstancin Rehabilitation Center. Fifty-four patients with symptoms of partial or complete cord injury were submitted to MR imaging. In four cases (7.5 per cent) epi- or subdural haematoma was found to contribute to neurological condition of the patient. MRI determines indications for surgical intervention.

Adolescent↗
PubMed1992

[Injuries of the cervical vertebrae with pathological changes caused by the degenerative process].

The problems related to injuries of the cervical spine with advances degenerative changes are discussed. The most frequent causes of these injuries were falls from height and traffic accidents. In the whole group of 185 patients most were aged over 50 years, and the lower part of the cervical spine was injured most frequently, with the extension mechanism being the usual force in the injury. Nearly half the cases (45%) had complete paralysis including the most severe form of partial injury.

Accidental Falls↗
PubMed1992

[Burst fractures of the cervical vertebrae].

A series of 237 patients with burst fracture of the cervical spine was treated between 1965 and 1991. These fractures usually result from head-on dive or fall from the height leading to quadriplegia. An early surgical decompression of the spinal cord and fusion of the spine at the site of injury from the anterior approach is the treatment of choice in author's opinion. It improves neurological and functional results of treatment, shortens hospitalisation time.

Accidental Falls↗
PubMed1991

An analysis of the results of transferring the musculocutaneous nerve onto the median nerve in tetraplegics.

Following injuries of the cervical spinal cord at the common level with C6 neurological level sparing, abduction of the shoulder and elbow flexion remain active. The flexors of the elbow are controlled by the musculocutaneous nerve formed mainly from C5 and C6 fibers, the motor cells of which are usually located above the level of the spinal lesion. The encouraging report of anastomosis of the musculocutaneous nerve to the median nerve, described by Benassy and Robart, induced us to perform similar operations in 42 patients with traumatic tetraplegia. In 32 patients this has restored simple grasping function of the hand, increasing the patients' independence. The operation is particularly indicated in cases of complete lesion of the spinal cord at the C6-C7 level in young people, and for best results should be performed with in the first few months after trauma.

Adolescent↗
PubMed1991

Differentiation of spinal damage through compression mechanism.

In the years 1965 to 1986, 986 patients with spine fractures caused by compression were treated at the Rehabilitation Clinic. This communication presents an analysis of those patients, taking into account the significant differences between typical compression fractures and explosion fractures, the latter are, as a rule, complicated by considerable or complete spinal cord damage. The author has pointed to the differences in the indication for surgery, different prognosis and significantly different results of treatment. The author is of the opinion that, due to those differences, the two kinds of spinal fractures should be considered separately with regard to the analysis of the mechanism of injury, the prognosis and the assessment of the results of treatment.

Adult↗
PubMed1991

The influence of the mechanism of cervical spine injury on the degree of the spinal cord lesion.

In the years 1965 to 1988, 1687 patients with cervical spine injury were treated in the acute post-traumatic period. In the analysed material commonest cause for the injury was by a flexion mechanism (48%), less frequently compressive (26%), and by a hyperextension mechanism (26%). Radiological changes were related, to some extent, with the patients age. Compression and flexion fractures occur most often in young people, dislocations in older ones, and injuries caused by hyperextension in, most often, elderly age (average age 53 years). The mechanism of the injury influences the degree of the nervous system injury. Serious consequences usually occur with crushing of a vertebral body. Serious neurological disturbance may occur with a flexion mechanism; and rarely such serious neurological disturbances accompany injuries caused by a compression mechanism. There was a complete lesion of the spinal cord in only 11% of patients. Neurological improvement was achieved in 51% of patients; 31% had no improvement, and 18% of patients died during treatment. The best results were observed in the group of typical compression fractures (neurological improvement--81%), whereas the poorest was found in patients with a crush type of fracture (improvement in 17%, mortality 18%), and in those with dislocation (improvement in 25%, mortality rate--23%).

Adult↗
PubMed1991

[Surgical treatment of neglected trauma related dislocations of the cervical vertebrae].

The series of 67 patients operated on for inveterate (more than 3 weeks since injury) trauma related dislocation of the cervical vertebrae between 1979 and 1990 is presented. Up to 3 months after injury an attempt to reduce the dislocation by means of the cranial traction has been undertaken. In cases of failure surgical reduction of the dislocation was performed. If this was unsuccessful in some cases the vertebral body narrowing spinal canal was removed. In 60% patients presenting neurological deficits a remarkable improvement was -- achieved what proves the surgical treatment to be useful even several months after injury.

Adult↗
PubMed1991

Anterior operations in cervicarthrosis and vertebral artery compression.

Pain in the cervical spine in the course of degenerative changes is a frequent complaint reported by patients seeking the help of various specialists. Depending on the location of pathologic changes, the pain in the spine may be accompanied by a whole array of signs and symptoms, which are sometimes more troublesome for the patient than the back pain itself. The symptoms are sometimes so persistent and difficult to treat that they lead the patient to apathy and depression, even to the point of suicidal attempts. Should serious aggravation of symptoms develop despite all efforts at successful conservative therapy, surgical treatment is employed to remove the osteophytes protruding into the lumen of the vertebral canal and compressing the spinal roots. An analysis from 1969 to 1988 of treatment in 237 patients with neurologic disorders and concomitant or dominant disturbances of blood flow in vertebral arteries showed that there are specific indications for surgical decompression of the arteries, i.e., when lumen is constricted by the osteophytes at the level of uncovertebral joints. In a series of 47 patients, 42 cases were found to be pain free.

Adult↗
PubMed1990

[Epidemiologic analysis of spinal injuries resulting from high falls].

A series of 1365 patients treated between 1965 and 1987 because of spine injury resulting from the fall from the height was analysed. A fall from the height may cause hyperflexion, axial loading or hyperextension type of injury. Hyperflexion injury occurs usually after fall from horsedrawn wagon, scaffold, roof or pillar. Axial loading injuries dominate in falls from the ladder, tree, suicidal jumps and falls from lower height. There is remarkable correlation among the height of the fall, degree of nervous system injury and results of management.

Accidental Falls↗
PubMed1990

[Open injuries of the spinal cord].

A series of 26 patients with stab, gun shot or other injury was presented. Good prognosis in partial spinal cord injury due to the stab wound was pointed out. Gun shot wounds usually resulted in total paresis even with little damage to the bony structures.

Adolescent↗
PubMed1990

[Stabilization of the fractured odontoid process with a compression screw].

The surgical technique for fractured dens stabilization with the use of compression screws was discussed. This method suggested by Böhler, in certain modification due to the equipment shortage, was applied in 8 patients operated shortly after injury has occurred. Relatively simple operative technique, good results, possibility to avoid head movements restrictions usually associated with posterior approach procedures makes this method valuable in certain cases especially in centers experienced in anterior approach spine surgery.

Adult↗
PubMed1990

[Spinal fracture in the course of spondylarthritis ankylopoietica (Bechterew disease)].

In 1965-1986 fifty-six patients were treated for fracture of the spine in the course of spondyloarthritis ankylopoetica. In 47 patients the cervical spine was injured. In 53 patients concomitant neurological symptoms were observed. Total or partial palsy were dominant in injuries of the cervical spine (72 per cent). A marked neurological improvement was achieved in the course of treatment in most of the patients. The authors recommend non-surgical treatment.

Adult↗