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Biomedical subjects

R A Callahan

Publications and source records attributed to R A Callahan.

10 recordsLinked to original sources
PubMed1977

Cervical facet fusion for control of instability following laminectomy.

Cervical laminectomy may compromise the stability of the spine. Posterolateral facet fusion can be used to stabilize the spine after laminectomy and prevent progressive deformity. The procedure includes passing wires through drill holes in the articular processes and binding two longitudinal struts of bone to the posterior columns of the articular processes. Sixty-three p atients with cervical laminectomy and facet fusion were reviewed, and fifty-two of them were followed for one to seventeen years. The reasons for fusion were to control overt spinal instability and deformity or to eliminate motion which may contribute to spondylosis. Solid fusion occurred in fifty of fifty-two patients at a mean of 6.5 months and provided continuing stability without progressive deformity. Although facet fusion is a complex procedure, it provides secure stabilization, does not interfere with decompression, and permits early mobilization of the patient.

Adolescent↗
PubMedDate not supplied

The value of computed tomography in spinal trauma.

Computed tomography (CT) is recommended for routine use in the evaluation of patients with spinal trauma. An evaluation of the CT scans and complementary radiographic studies of 117 patients with spinal trauma was performed. CT provides critical information often not afforded by conventional radiographs concerning fractures, bullet fragments, surgical devices, and paraspinal pathology. Furthermore, in contrast to myelography, it can demonstrate directly certain soft-tissue abnormalities within the spinal canal, such as intramedullary hematomas, herniated discs, and posttraumatic syrinxes. CT can also determine the etiology of myelographic defects, including those causing total myelographic blocks. Further, aided by intrathecal metrizamide, it can differentiate cord swelling from extrinsic cord pressure and thereby demonstrate the need for medical or surgical therapy.

Adolescent↗
PubMedDate not supplied

Acute spinal cord injury: current concepts.

Optimal treatment of acute spinal cord damage requires an effective emergency medical service at the scene of injury coordinated with a hospital-based multidisciplinary team of physicians and allied health professionals. A detailed protocol outlines the steps required for evaluation, supportive therapy and stabilization. Emphasis is placed on team work with equal attention directed to nervous tissue and spinal column lesions. Laboratory and clinical investigations regarding spinal cord injury are directed toward epidemiology, anti-inflammatory agents, biomechanics, physical therapy and reconstructive surgery.

Angiography↗
PubMedDate not supplied

A rational approach to burst fractures of the atlas.

The stability of a burst fracture of the atlas (Jefferson's fracture) should be determined in order to decide upon the appropriate treatment. Unstable fractures include those with a rupture of the transverse ligament, or those in which union has been incomplete despite treatment. An occiput-to-C2 or in atlantoaxial arthrodesis may be indicated.

Adult↗
PubMedDate not supplied

Positioning techniques in spinal surgery.

By keeping in mind the principle of stability, ease of exposure and physiologic restrains on the patient, the optimum safe positioning technique for successful spinal surgery can be selected. We recommend skeletal or head-halter traction for anterior exposure of the cervical spine. Gardner's three-point skeletal fixation or halothoracic immobilization are the methods of choice for posterior cervical spine exposure. Either rolled towels or the Relton-Hall frame are preferred for posterior thoracolumbar surgery. Specific attention to protection of the eyes, bony prominences and peripheral nerves is essential.

Cervical Vertebrae↗
PubMedDate not supplied

Cervical orthoses: a guide to their selection and use.

A large variety of cervical orthoses is available, but these may be divided into four basic groups. Although the orthoses in each group provide similar controls, each appliance has certain discrete advantages and limitations. The effectiveness of seven different cervical appliances in restricting motion in flexion-extension, lateral bending and rotation is presented. This information may be used to rationally select an orthosis to control specific clinical problems. A guide is formulated for selecting the orthoses for the control of various cervical injuries and postoperative problems.

Adult↗