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Biomedical subjects

O Troisier

Publications and source records attributed to O Troisier.

14 recordsLinked to original sources
PubMed1991

[Tennis elbow].

Tennis elbow is most often due to a tendinitis of the extensor carpi radialis brevis, and occasionally of the extensor digitorum. Pain felt at the outer aspect of the elbow, is elicited by grasping. Passive movements are painless, and of full range, excepted for extension, and varus strain tested in slight flexion. Isometric contraction of all the muscles controlling the joint are painless, excepted resisted extension of the wrist. The most usual painful spots lay on the lateral epicondyle, or lower on the common tendon. Diagnosis is confirmed when signs disappear immediately after a correct injection of lignocaine, and persist at least 3 Weeks if a corticoïd is added. The two outstanding differential diagnoses are internal derangement of the humero-radial joint, and entrapment of the sensory branch of the radial nerve. Many treatments are indicated. In a series of 58 cases, cervical manipulations give in most cases only a temporary relief; deep transverse massage applied on the tendon below the epicondyle, gives in a series of 131 cases good and excellent results in 63% of the cases. In a series of 257 cases, injections of corticoïds gives full relief in all cases, but the rate of recurrences is 66.7%, although 67% of those recur only once or twice. Percutaneous tenotomy performed only in patients recurring after temporary cure, drops the rate of recurrences to 13%. The last alternative is open surgery, releasing the common tendon.

Humans↗
PubMed1986

Discography: an element of decision. Surgery versus chemonucleolysis.

It is a well known fact that both surgery and chemonucleolysis can cure a patient suffering from root pain due to a prolapsed intervertebral disc. However, the failure rate after intradiscal injection of chymopapain remains important. Analysis of the cases operated after unsuccessful chemonucleolysis show that about two thirds are due to a remaining discal fragment. Considering the possibility of a bad penetration of the enzyme in the herniated area, neither computed tomography (CT) scan nor myelography, but only discography, can demonstrate invasion of the prolapsed area. On a series of 165 patients injected with chymopapain in only one disc, discographic data were correlated with the result of the treatment on the root pain. Three items were analyzed: the size of the protruding area located at the back of the disc (closely related to operative findings, as shown on a previous study), the density of the contrast medium filling the protruding area, and the pain response during the injection. A large, well-filled protruding area characterizes a "good" image and correlated with 76% of good results. Likewise when the pain response is lateralized (in the buttock or the affected lower limb), it correlates with 42% of success and 13% of failures. In 24.8% of the cases a combination of good images and lateralized pain correlates with 97.5% of good results. Therefore discography should be an element of decision between surgery and chemonucleolysis, and should be considered as a preoperative examination.

Adolescent↗
PubMed1982

[Evaluation of 5 years of nucleolysis treatment in 150 cases of radiculalgia and 10 cases of lumbago of disk origin].

The action of chemical nucleolysis on lumbar disc/root problems was assessed on the basis of 4 parameters: root pain, neurological deficit, residual lumbar pain and spinal mobility evaluated by the Shöber test, at 4 months, 1 year, 2 years, 3 years and more. With time, mean results concerning root pain disappeared; neurological deficit and root pain progressed in parallel with good or excellent results of the order of 75 percent; residual lumbar pain remained stable, null in 30 percent of cases and very troublesome in 15 per cent of cases. Mobility increased with time: when good or excellent, nor poor results were seen in terms of lumbar pain or root pain.

Adolescent↗
PubMed1982

[Technic of extradural diskography].

Extra-dural discography is an ambulatory investigation. The exact technique is based upon three principles: a) the patient is in a 3/4 position on the table; b) follow the direction of the actual central ray or of a correction applied to it when the disc is impacted. This correction is made using a ruler, abacus and goniometer placed on the support of the tube; c) use of a range of special needles, certain of which have been curved at the time of manufacture. Interpretation of the results of a series of 121 cases of sciatica treated surgically after discography has confirmed the reliability of the method as shown by operative findings in particular when discography has shown a protrusion of 5 mm or more (94% of results showing agreement). Amongst degenerated discs, the distinction must be drawn between those without a protrusion and those with, hence the value of measuring the raised area caused by the contrast medium in the epidural space. Finally, the existence of an epidural leak is compatible with all the types of lesion seen.

Epidural Space↗
PubMed1980

[The treatment of lumbosciatica by intra-discal injection of proteolytic enzymes (nucleolysis). 80 cases (author's transl)].

Proteolytic enzymes originated from carica papaya, injected extra durally in the lumbar intervertebral disc of 80 patients suffering from intractable root pain due to herniated discs, led to 85% of satisfactory results as far as root pain is concerned. Strong motivation and appropriate deals with residual lumbar pain which was absent or kept under control in 85% of all cases. Surgery can be successfully carried out after nucleolysis, when an adherent root and/or an extruded fragment is responsible of the failure.

Adult↗