PubMed HealthSearch

Biomedical subjects

P Kehr

Publications and source records attributed to P Kehr.

At least 19 recordsLinked to original sources

[Surgery for backache].

All types of lumbar pain are of course not an indication for surgery. However, an operation may bring relief from lymbodynia in given conditions, owing to the better knowledge of spinal physiopathology and to the evolution of the surgical technique. This is the case for intervertebral disk pathology, lesions of the posterior articular structures, lumbar canal stenosis, vertebral tumors or malunions, as well as for some cases of painful frontal or sagittal deviation of the spine. State-of-the art techniques utilize arthrodesis, often with a plate or CD-material osteosynthesis, but future surgery should be aimed at preserving motion.

Back Pain

[Study by radioactive microspheres of bone microcirculation in aseptic osteonecrosis of the femoral head].

Thirty-two hips affected by aseptic necrosis, four of them post-traumatic and 12 contralateral hips thought to be healthy have been studied by combining superselective arteriography with the injection of radioactive microspheres. It has been possible to show that aseptic necrosis begins with a global ischaemia and is followed by an incomplete revascularisation leaving a necrotic area. On the border between the two areas hypervascularity produces a zone of fragility where microfractures develop with detachment of a sequestrum. The presumed opposite hip is almost always, even in traumatic lesions, the site of a hypovascularity which seems to suggest a predisposition to the lesion. There is a correlation between radiological and clinical worsening and the development of revascularisation in the femoral head.

Femur Head

Sacral meningeal arteriovenous fistula fed by branches of the hypogastric arteries and drained through medullary veins.

The authors report a new case of intraspinal extra-medullary meningeal arteriovenous fistula draining through medullary veins. Discovered in a 33-year-old black man suffering from a cauda equina syndrome, this malformation suspected in myelography was confirmed by a selective angiographic procedure of both internal iliac arteries. This investigation specified the sacral site of the fistula as well as its feeding arteries from several branches of the left and right internal iliac arteries and its posterior and intra-meningeal venous medullary drainage. An embolization procedure followed by a surgical approach and a second embolization session brought a fair improvement to this young patient who could walk again. The acquired traumatic origin of the fistula is discussed for this patient who had been previously operated at his L5-S1 level.

Adult

[Uncoforaminectomy of Jung in the management of osteoarthritis of the cervical spine and the post-traumatic cervical syndrome (author's transl)].

An anterolateral approach to the cervical spine with uncoforaminectomy is used to free the intra transverse portion of the vertebral artery (from C7 to C3) and the nerve roots. Four surgical indications are discussed; the cervicocephalic syndrome due to osteoarthritis of the joints of Luschka, the cervicobrachialgic syndrome which is often combined wirth the former, cervical myelopathy associated with osteoarthritis and the post-traumatic cervical syndrome. Clincal and neuro-radiological details are given. The results of operation are described in 149 cases and they have been successful in 82%.

Brachial Plexus Neuritis

[Arthroplasty of the hip by cemented coupled cups. A new technique (author's transl)].

A presentation of a technique of arthroplasty using cemented coupled cups which has been used in 50 cas over a period of more than a year. The hip is approached via an anterolateral incision with the patient in a dorsal horizontal position. This cemented cup arthroplasty has all the advantages of a classical total prosthesis: solid fixation, minimal rubbing by the use of a metal head and an acetabulum in high density polyethylene. However, it has none of the disadvantages since little cement is used, the medullary cavity is not opened and, above all, the neck of the femur is preserved, thereby rendering possible any later operation which may be necessary. The technique is described in detail and the indications rapidly reviewed.

Arthroplasty

[Cylindrical osteotomy of the upper end of the tibia [author's transl)].

The authors describe a modification of the original technique of Blaimont and Maquet. Cylindrical osteotomy allows correction of deformity in the frontal plane (genu varum or valgum) with forward displacement of the tibial tuberosity. The technique and instruments are described. The osteotomy is fixed by screws and joint mobilisation is begun after two weeks. Thirty patients have been operated on. The results are described as satisfactory.

Aged

[Rupture of the rotator tendon].

The authors report 25 cases of rupture of the rotator tendons operated on at the Stephanie Hospital in Strasburg, and discuss the surgical indications. Debeyre's technic was used with satisfactory overall results both on pain and function.

Adult

[Uncusectomy and uncoforaminectomy according to Jung. Technique, indications and results (author's transl)].

The authors described the technique of uncusectomy and uncoforaminectomia according to A. Jung. The Jung-operation can be defined as the opening of the intervertebral foramina through the anterior approach. The aims of this operation are the liberation of a displaced or narrowed vertebral artery and to free compressed or irritated nerve roots by means of opening and widening the intervertebral foramina from the front. This report is based on 180 such operations performed by A. Jung and colleagues. The operation is indicated whenever cervical uncarthrosis leads to a vertebrobasilar insufficiency syndrome or a cervical-brachial irritation syndrome. Both syndromes commonly occur together. The results of operative treatment are analysed and the success rate lies around 80%.

Cervical Vertebrae