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Biomedical subjects

L T Kurz

Publications and source records attributed to L T Kurz.

8 recordsLinked to original sources
PubMed1992

Surgical management of myelopathy.

We have presented a comparative analysis of the ability of four surgical procedures to address adequately the problems sustained by a patient with symptomatic cervical myelopathy. AIA is a safe procedure whose effectiveness may be limited when the extent of disease is more than three intervertebral disk levels. ACA permits more direct and extensive access to the spinal cord and is the procedure of choice for cervical spondylotic myelopathy associated with spinal deformity. However, rigid external immobilization is necessary, and operative morbidity may be greater. Cervical laminectomy may be effective for decompressing the spinal cord when no associated spinal deformity or instability is present, provided that extensive resection of facet joints is avoided. Cervical laminaplasty is ideally suited for the patient with three or more levels contributing to a cervical myeloradiculopathy. Mild instability may be addressed by performing arthrodesis on the hinge side.

Adult↗
PubMed1991

Modified anterior approach to the cervicothoracic junction.

The surgical management of tumors at the cervicothoracic junction is hindered by various anatomic structures. Standard approaches to the cervical or thoracic spine provide inadequate exposure. An approach to the cervicothoracic junction that provides exposure from C3 to T4 is described. The approach allows extensive bony resection, spinal cord decompression, correction of deformity, spinal reconstruction, and stabilization. Four patients with tumors metastatic to the cervicothoracic junction underwent this surgical approach. All had significant kyphosis and neck pain unresponsive to nonsurgical treatment. After surgery, neurologic function improved in three patients and remained normal in one. All patients had relief of neck pain and reduction of kyphosis.

Adult↗
PubMed1991

Degenerative lumbar spondylolisthesis with spinal stenosis. A prospective study comparing decompression with decompression and intertransverse process arthrodesis.

Fifty patients who had spinal stenosis associated with degenerative lumbar spondylolisthesis were prospectively studied clinically and radiographically to determine if concomitant intertransverse-process arthrodesis provided better results than decompressive laminectomy alone. There were thirty-six women and fourteen men. The mean age of the twenty-five patients who had had an arthrodesis was 63.5 years and that of the twenty-five patients who had not had an arthrodesis, sixty-five years. The level of the operation was between the fourth and fifth lumbar vertebrae in forty-one patients and between the third and fourth lumbar vertebrae in nine patients. The patients were followed for a mean of three years (range, 2.4 to four years). In the patients who had had a concomitant arthrodesis, the results were significantly better with respect to relief of pain in the back and lower limbs.

Aged↗
PubMed1990

Surgical management of cervical soft disc herniation. A comparison between the anterior and posterior approach.

Anterior cervical fusion was initially described in the 1950s for cervical spondylotic radiculopathy. The indications for this procedure in the management of soft disc herniation have not been clearly defined. In addition, controversy exists as to whether a cervical soft herniation should be managed by an anterior approach or a posterior cervical laminotomy-foraminotomy. The authors report the results of a prospective study comparing anterior discectomy and fusion to posterior laminotomy-foraminotomy for the management of soft cervical disc herniation. Twenty-eight patients underwent anterior discectomy and fusion (Robinson horseshoe graft) while 16 patients underwent posterior laminotomy-foraminotomy. The disc herniations were classified into two types. Type I were single level anterolateral herniations (33 patients) while type II were central soft disc herniations (11 patients). Clinically, patients with type I herniations manifested signs and symptoms of radiculopathy while patients with type II herniations manifested signs of myelopathy or neck pain and bilateral upper extremity paresthesias in 4 patients. Confirmatory studies were myelography in 12 patients, myelography combined with computed tomography (CT) in 26 patients, and magnetic resonance imaging (MRI) in 6 patients. For type I herniations, 17 patients underwent anterior fusion while 16 patients had a posterior laminotomy-foraminotomy. The 11 patients classified as type II herniation all underwent anterior discectomy and fusion. There were 27 men and 17 women. The age range was 21 to 52 years (mean, 41 years). The follow-up was 1.6 to 8.2 years (mean, 4.2 years).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1989

Harvesting autogenous iliac bone grafts. A review of complications and techniques.

Autogenous bone grafts from the ilium are frequently harvested for purposes of bone union and/or stability. Although some donor site complications may be unavoidable, awareness of the anatomy and complications may aid in planning the approach and minimizing the risks. Documented donor site complications include pain, nerve and arterial injury, peritoneal perforation, sacroiliac joint instability, and herniation of abdominal contents through defects in the ilium. Strict observation of relevant anatomic considerations will help in avoiding these complications.

Abdomen↗
PubMed1987

Symptomatic intraspinal synovial cysts: opacification and treatment by percutaneous injection.

Intraspinal synovial cysts are usually located in the lower lumbar spine in association with osteoarthritis of the facet joints, and they are most accurately diagnosed by using CT. Surgical removal of intraspinal synovial cysts implicated in the development of radiculopathy has resulted in symptomatic relief. A nonoperative method of treatment consists of CT-guided needle placement into the facet joint adjacent to the cyst, followed by injection of contrast material to show communication between the joint and the cyst and injection of corticosteroids. Three outpatients were treated in this fashion without complications. Complete relief of symptoms was achieved in two cases and partial relief was achieved in one. Follow-up CT scans performed 2 months after the procedure showed no change in the size of the cysts in two of the patients. A 6-month follow-up CT scan in the third patient, however, showed significant improvement in cyst size. These preliminary results suggest that this procedure is an alternative to surgical management of intraspinal synovial cysts.

Humans↗
PubMed1985

Intraspinal synovial cyst causing sciatica.

Four patients who had low-back pain and sciatica were diagnosed as having a lumbar intraspinal extradural synovial cyst adjacent to a facet joint between the fourth and fifth lumbar vertebrae. The patients ranged in age from forty-nine to seventy-one years, and the symptoms and signs involved the fourth or fifth lumbar-nerve roots. Roentgenographically, degeneration of the intervertebral discs and facet joints was noted in every patient. Degenerative spondylolisthesis was also a frequent finding. Myelography and computed tomographic scans aided in diagnosis, revealing a soft-tissue lesion, occasionally rimmed with calcification, adjacent to the involved facet joint. The treatment was surgical excision of the cyst, as well as complete laminectomy if there was concomitant spinal stenosis. Follow-up, ranging from eighteen to twenty-five months, revealed complete resolution of the sciatica in all patients.

Aged↗