PubMed Health⌕ Search

Biomedical subjects

R O Kissling

Publications and source records attributed to R O Kissling.

At least 19 recordsLinked to original sources
PubMed2000

Positional MR imaging of the lumbar spine: does it demonstrate nerve root compromise not visible at conventional MR imaging?

PURPOSE: To evaluate whether positional magnetic resonance (MR) images of the lumbar spine demonstrate nerve root compromise not visible on MR images obtained with the patient in a supine position (conventional MR images). MATERIALS AND METHODS: Thirty patients with chronic low back pain unresponsive to nonsurgical treatment and with disk abnormalities but without compression of neural structures were included. Positional MR images were obtained by using an open-configuration, 0.5-T MR imager with the patients seated and with flexion and extension of their backs. The disk and nerve root were related to the body position. Nerve root compression and foraminal size were correlated with the patient's symptoms, as assessed with a visual analogue scale. RESULTS: Nerve root contact without deviation was present in 34 of 152 instances in the supine position, in 62 instances in the seated flexion position, and in 45 instances in the seated extension position. As compared with the supine position, in the seated flexion position nerve root deviation decreased from 10 to eight instances; in the seated extension position, it increased from 10 to 13 instances. Nerve root compression was seen in one patient in the seated extension position. Positional pain score differences were significantly related to changes in foraminal size (P =.046) but not to differences in nerve root compromise. CONCLUSION: Positional MR imaging more frequently demonstrates minor neural compromise than does conventional MR imaging. Positional pain differences are related to position-dependent changes in foraminal size.

Adult↗
PubMed1999

Sacroiliac joint innervation and pain.

The present paper reviews current knowledge on the innervation of the human sacroiliac joint (SIJ). We conclude, based on a recent anatomic study on adult cadavers, with fetal correlation, that the joint is predominantly, if not entirely, innervated by sacral dorsal rami. This conclusion is in agreement with patterns of referred pain reported by asymptomatic volunteers upon direct SIJ capsular stimulation and with a reduction in pain in patients treated for (presumptive) SIJ pain by injection of an anesthetic into the SIJ. We also present preliminary data suggesting that the periarticular tissues of the SIJ, like those of other synovial joints, contain mechanoreceptors and nociceptors that function to inform the central nervous system about the state of the joint.

Adult↗
PubMed1997

Blood vessels of the sinus tarsi and the sinus tarsi syndrome.

This study describes the arterial and venous blood vessels in the sinus tarsi of a series of nine anatomical specimens and in a traumatically amputated leg, studied by arteriography. The sinus tarsi artery was formed in all cases from anastomoses between various arteries of the lateral region of the foot. These usually included the anterior lateral malleolar, and proximal lateral tarsal arteries; in 70% there was a branch from the distal lateral tarsal artery, and in 30% a branch from the peroneal artery. In all cases, there were anastomoses within the sinus tarsi between the sinus tarsi artery and the canalis tarsi artery, derived from the posterior tibial artery. Whatever its origins, the sinus tarsi artery was the principal supplier of intrasinusal structures and of the talus. There was a large venous plexus in the sinus tarsi, which drained particularly the venous outflow from the talus and the anterior part of the capsule of the posterior talocalcaneal joint to the lateral and medial venous systems of the foot. Posttraumatic fibrotic changes in the wall and surrounding tissue of the veins, causing disturbance of venous outflow and increased intrasinusal pressure, are proposed by the authors as one possible factor in the pathogenesis of the sinus tarsi syndrome.

Arteries↗
PubMed1996

A prospective controlled study of low back school in the general population.

There are no data on the efficacy of a back school in primary prevention of back pain in the general population or on the characteristics of the population who volunteers. After announcement in the local press, 494 healthy adults volunteered and paid for a back school course in Switzerland. A total of 371 controls were matched for sex, age, profession, nationality and back pain. A statistically significant decrease in numbers of doctor's visits was found by the participants during the following 6 months compared with the controls. However, there were no significant between-group difference in the four remaining parameters (presence and intensity of back pain, drug intake and sick leave). Three-quarters of participants changed their attitudes after the back school. Volunteering for a back pain prevention programme was associated with the presence of back pain problems. Reasons for volunteering are further discussed. Overall, the results of this study showed that a back school for the general population may not solve the problem of low back pain, but improves self-help in a subgroup of the population.

Adult↗
PubMed1996

The mobility of the sacroiliac joint in healthy subjects.

A three-dimensional stereophotogrammetric method is described for measuring the mobility of the sacroiliac joint, which was based on preliminary two-dimensional in vitro experiments. The investigations were carried out with intraosseous markers in 24 healthy volunteer male (15) and female (9) subjects having an age range of 20 to 50 years. Considerable intra- and inter-individual variability was found for both the measurements of rotation and translation. The position and direction of the movement axes showed wide variations, but a basic pattern could always be recognized. The average values for rotation and translation were low, being 1.8 degrees / 0.7 mm for the males and 1.9 degrees / 0.9 mm for the females. No statistically significant differences could be demonstrated with respect to either sex or age. On the basis of the measurement results, it is postulated that there is pathological sacroiliac joint movement when rotation is more than 6 degrees and translation more than 2 mm. This increased mobility seems to be of greater clinical significance than reduced mobility.

Adult↗
PubMed1995

The mobility of the sacroiliac joints in healthy volunteers between 20 and 50 years of age.

The nature and amplitude of movement in the sacroiliac joint (SIJ) is still open to controversy. Whereas some authors using modern measuring techniques have reported on the range of motion in the SIJ of patients and in embalmed elderly humans, the following is a presentation of our observations related to healthy individuals between 20 and 50 years of age. Using a three-dimensional stereophotogrammetric method, the motion in the joints of 15 males and nine females was investigated with change in posture from the upright standing position. The general description of spatial motion, as obtained through the helical axis concept, has been used. For comparison of the results obtained, the motion is also specified as components of rotation about vertical, anteroposterior and transverse axes, or in horizontal, frontal and sagittal planes respectively. The average values for total rotation and translation were low, being 1.7 degrees and 0.7 mm respectively. One of the test subjects who was known to have occasional trouble with his sacroiliac joints exhibited more than 6 degrees rotation. No statistically significant differences could be demonstrated with respect to sex, age, or parturition. RELEVANCE:--No data are available in the literature on the motion of the sacroiliac joints of healthy men and women in the age group 20-50 years. Measurements were carried out with the aid of percutaneously introduced external markers, using conventional light photography. This is a definite advantage over the use of X-rays and radio-opaque markers that would probably remain implanted in the bone indefinitely. Therefore this method might also be considered for future use in clinical research involving the mobility of the SIJ in patients.

Journal Article↗
PubMed1992

[Manual medicine of the spine--indication, diagnostic and therapeutic possibilities].

Manual medicine developed rapidly during the last 40 years and became an integral part of standard medicine. The basic idea behind the methods used is that several acute and chronic disorders the spine and peripheral articulations are caused by functional disturbances in one or more spinal motion segments, and also in peripheral joints, always accompanied by reflectory muscular reactions. These changes must be detected and treated specifically. The diagnosis for manual therapy is always complementary to general medical examination. Knowledge of absolute and relative contraindications is the basis for every manual therapy. Therapeutically, apart from the actual mobilization with or without impulse, the so-called neuromuscular techniques are used; these are acting together with the muscle force of the patient and with the thereby triggered reflex-mechanisms. Whereas the latter techniques are also used in physiotherapy, mobilization with impulse should be practised nowadays only by trained physicians and chiropractitioners, since the risks involved are considerable. It is of great importance that the therapy is not limited just to the manipulation of the functionally disturbed motion segment but that in addition muscular disbalance is treated.

Contraindications↗
PubMed1992

[Ergotism of the locomotor apparatus--a sometimes forgotten diagnosis?].

The alcaloids from rye-ergot are known and used for their vasoconstrictive properties, which can induce secondary ergotism. The extremities will be particularly involved. Vasoconstriction will also concern the gastrointestinal tract as well as the peripheric and the central nervous system, possibly with neuro-psychiatry symptoms. Cardiac and renal involvement has been described. Migraine, thrombosis prophylaxis and obstetrical situations are the most frequent therapeutic indications. Precise patient history, clinical and the typical angiological findings are necessary for diagnosis. The importance of an early diagnosis is emphasized. The responsible agent can then be stopped with thorough in-time vasodilatating treatment, and restitution will occur. Three cases are reported. The patients were referred to the rheumato-orthopedic clinic because of limbs claims. They suffered from different grades of ergotism, and one had to be amputated at the right hand. The following discussion is based on a review of the literature.

Adult↗
PubMed1991

[Cutaneous panarteritis nodosa: suggestion of diagnostic assessment for a benign disorder. 2 personal cases and review of the literature].

The diagnosis of cutaneous panarteritis nodosa, a local, isolated condition of good prognosis, requires the elimination of any systemic involvement. Two personal cases, together with a review of the literature, serve to demonstrate the benign nature of the condition, with the absence of systemic complications during a mean medical follow-up of 9 years. However, the condition is not entirely innocuous since it required the administration of corticosteroids in 71% of cases. The outcome was complete recovery in 32% of cases, and improvement or stabilisation in 51%, with no information provided in 16%. Complete recovery was obtained in the author's two cases: one spontaneously and one with corticosteroid therapy. The good prognosis justifies the suggestion of a relatively non-invasive diagnostic assessment. Medical follow-up is required if symptomatology persists or if steroids are prescribed, but is not necessary when there is complete recovery.

Adult↗
PubMed1991

[Prevention of recurrence of Sudeck's disease with calcitonin].

In patients suffering from, or with a history of, reflex sympathetic dystrophy (RSD), there is always a risk of exacerbation or reactivation of this disease after surgery or trauma. The use of calcitonin in the treatment of this type of disorder is well established. Starting in 1984, 18 patients with clinical symptoms of RSD or a history of this disease were given daily prophylactic treatment with salmon calcitonin (100 IU subcutaneously or as a spray). Ten of the patients underwent orthopaedic surgery and 8 received conservative treatment following trauma. The mean duration of prophylactic treatment was 4 days before and 23 days after surgery or trauma. Only one recurrence was observed (3 per cent). For comparison, a retrospective analysis of a group with the same inclusion criteria who underwent surgery or received conservative treatment after trauma, without prophylactic administration of calcitonin showed a recurrence of the underlying disease 28 per cent of the cases. It is therefore possible to recommend prophylactic administration of calcitonin, to patients with a history of RSD who are about to undergo orthopaedic surgery or conservative treatment following trauma.

Adult↗
PubMed1990

[Evaluation and treatment of Scheuermann's disease].

Scheuermann's disease is considered a kyphoscoliotic process of specific segments of the vertebral column expanding on the original definition of thoracic hyperkyphosis. More important for prognosis than the description of anomalies of single vertebrae is the competent assessment of static imbalance. Because of lacking long-term results no strategies for treatment can be recommended today. Conservative as well as surgical therapies are laborious and their success often rather limited.

Adolescent↗
PubMedDate not supplied

[Is open synovectomy of the metacarpophalangeal joint in chronic polyarthritis worthwhile?].

UNLABELLED: PURPOSE/METHODS/PATIENTS: This work retrospectively analysed 252 synovectomies performed on 153 patients from 1958 to 1995 at the Balgrist University Orthopaedics Clinic, and evaluated the short-term and long-term benefits of open synovectomy of the metacarpo-phalangeal joint in rheumatoid arthritis. RESULTS: Rheumatoid arthritis (n = 182) was by far the most common of the 21 different diagnoses involved, and the metacarpo-phalangeal joint (n = 101) was by far the most frequently operated of the 7 different joint types in question. In the short tenn (n = 97), after a mean of 5.5 months, open synovectomy of a metacarpo-phalangeal joint in rheumatoid arthritis patients provided a benefit in terms of mobility in 85% of cases and in terms of joint swelling and pain in 93% of cases. Among one-third of the originally operated cases (n = 38), long-term benefit, i.e. after a mean of 6.9 years, was obtained in 89% of cases with regard to joint mobility, 87% with regard to swelling and 97% with regard to pain relief. Two-thirds of the joints presented normal mobility and swelling, and three-quarters were pain-free. CONCLUSIONS: The metacarpo-phalangeal joint is very important for maintaining the independence of a patient (gripping). Open synovectomy of the metacarpo-phalangeal joint in rheumatoid arthritis patients is an effective therapeutic procedure with little morbidity and very good long-term benefit in the management of metacarpo-phalangeal pain, swelling and stiffness refractory to conservative therapy.

Arthritis, Rheumatoid↗