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J R Meerschaert

Publications and source records attributed to J R Meerschaert.

9 recordsLinked to original sources
PubMed1992

Electromyographic detection of paraspinal muscle metastasis. Correlation with magnetic resonance imaging.

Electromyographic (EMG) examination demonstrating marked segmental compromise of the posterior primary ramus distal to the spinal root with relative sparing of the anterior ramus may be the earliest objective evidence of paraspinal muscle metastasis. Antecedent studies are often initially normal, failing to disclose the underlying cause of back pain. Although paraspinal muscle metastasis has been histopathologically demonstrated at postmortem, attempts to image the suspected malignancy with computed tomography have been unsuccessful because the tumor in muscle remains isodense. This study reports the use of magnetic resonance imaging (MRI) to substantiate the existence of EMG-suspected paraspinal muscle metastasis. An EMG pattern of segmental posterior primary ramus denervation is not pathognomonic of metastasis. A confirmatory MRI, however, does permit earlier treatment with palliative radiation therapy.

Adenocarcinoma↗
PubMed1992

Intermittent cervical traction: a progenitor of lumbar radicular pain.

Twelve patients treated with cervical traction for complaints of cervical radicular pain subsequently developed lumbar radicular discomfort. Intermittent cervical traction therapy had been initiated at 15 pounds and increased to 30 pounds. Lumbar spine roentgenographs in four patients demonstrated a transitional lumbar vertebrae and ten patients had evidence of spinal osteoarthritis with associated degenerative changes. Abnormal electroneuromyographs were found in four patients. In two additional patients with normal electromyographs, the spinal evoked potentials were asymmetrically slowed suggesting chronic lumbar root compromise. The onset of lumbar radiculopathy after intermittent cervical traction suggests that axial tension induced in the spinal cord's dural coverings can be transmitted to lumbar nerve roots. When these structures are tethered by anatomic variants and/or associated degenerative changes, spinal root excursion may be limited, and lumbar pain may be precipitated by traction.

Adult↗
PubMed1979

Breast pain: a symptom of cervical radiculopathy.

Eighteen women, all of whom had extensive but noninformative breast evaluations, including 10 mammograms and 4 biopies, were successfully treated by cervical traction for chronic breast pain. Each patient had distinct clinical or electromyographic evidence of cervical root compromise. Fifteen had roentgenographic evidence of cervical spondylosis, primarily at levels C6 and C7. Cervical angina, as a symptom constellation produced by cervical radiculopathy and mimicking coronary ischemic disease, is a well-defined entity. Less well recognized is persistent breast pain as a primary presenting symptom of cervical root compromise. In both instances, the early identification of the cervical radicular origin of the pain, with its quite different prognosis and associated therapeutic implications, can promptly help to allay the patient's physical and psychologic discomfort. The pathologic mechanism of pain production and the anatomic pattern of referral are described.

Adult↗
PubMed1978

Symphyseal and sacroiliac joint pain associated with pubic symphysis instability.

Fifty patients presenting with lumbosacral and inguinal pain were examined by routine clinical radiographic and electromyographic evaluations. All were without antecedent history of major pelvic trauma or spinal surgery but demonstrated evidence of pubic symphysis instability. Slip between the pubic rami in excess of 2 mm could be demonstrated in each with alternate leg weight bearing. Asymmetry of hip mobility on the symptomatic side with a reduction in abduction and external rotation was present in 20 patients. An approach to treatment of pain associated with pubic symphyseal and associated sacroiliac joint instability is described, combining both intraarticular steroids, lumbosacral supports and physical therapy modalities.

Adolescent↗
PubMed1978

Metastatic disease of the paraspinal muscles: electromyographic and histopathologic correlation in early detection.

Electromyographic examination may demonstrate severe segmental compromise of the posterior primary ramus and relative sparing of the anterior ramus as the earliest objective evidences of spinal and paraspinal metastases. Antecedent studies, including roentgenographic, radioisotopic and neurologic investigations, are often initially normal, failing to reveal the underlying cause of the progressive back pain. The present report demonstrates metastatic spread both through the paravertebral venous plexus and by direct extension in contiguous muscle. In this special instance, segmental 4+ fibrillations in the paraspinal muscles are electrophysiologic manifestations of a local, active process of denervation rather than a remote effect of the malignant disease, as has been suggested by others.

Adenocarcinoma↗
PubMed1977

Carotid bruits: their significance in the cervical radicular syndrome.

Routine physical examination of 600 patients referred with complaints of neck or shoulder pain included auscultation of both carotid and subclavian arteries. A treatment regimen including consideration of therapeutic cervical traction was precluded in 11 patients when unilateral carotid bruits were heard. Subsequent testing including radioisotopic carotid blood flow studies, and arteriography demonstrated 1 thoracic outlet syndrome, 1 arteriovenous malformation, 1 scarring secondary to radical neck dissection, 1 extrinsic pressure from an epidermoid carcinoma, 5 partial carotid occlusions secondary to intra-arterial plaque formation, and 2 normal carotid contrast studies. Successful surgery in all five of the stenotic patients and in the case of arteriovenous malformation aborted what might have otherwise been a less satisfactory outcome.

Adult↗