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Biomedical subjects

R Roy-Camille

Publications and source records attributed to R Roy-Camille.

At least 19 recordsLinked to original sources
PubMed1992

Three-dimensional geometrical and mechanical modelling of the lumbar spine.

The main objective of this study is to design a three-dimensional geometrical and mechanical finite element model of the lumbar spine. The model's geometry is constructed using six parameters per vertebra. These parameters are digitized from two X-rays (anterio-posterior and lateral), thus yielding an individualized model which can be arrived at from the radiographs of a tested specimen. This procedure makes the model validation easier, as geometry is generally a factor of dispersion in experimental results. The geometrical reconstruction, in the form of a finite elements mesh, was effected for the whole lumbar spine. The global coherence of the model was verified.

Humans↗
PubMed1992

Treatment of lower cervical spinal injuries--C3 to C7.

Injuries of the lower cervical spine are categorized according to the morbid anatomy of the lesion. Most often, such injuries are successfully treated by surgery through a posterior approach. After anatomic restoration, internal fixation with plates and screws provides for stability and arthrodesis. Of 221 cases of lower cervical spine injuries, posterior stabilization was accomplished in 89%. There was no secondary displacement in 85% of cases.

Cervical Vertebrae↗
PubMed1992

Management of fracture separations of the articular mass using posterior cervical plating.

Fracture separations of the articular mass are a specific group of unilateral facet fractures that must be considered separately because of their unique two-level instability. This fracture pattern involves a longitudinal fracture of the lamina and a fracture of the pedicle on the same side of the spine at the same level. It is characterized roentgenographically by horizontalization of the lateral mass, with a mean translation of 4.6 mm and a mean angulation of 6.9 degrees. In this study the deformity most commonly occurs at the level below the fracture (19 patients) but also occurred at the level above (5 patients). There is a high incidence of neurologic involvement (14 of 24 patients), most often radicular in nature. This injury results in two level instability requiring a three-level, two-interspace stabilization. All twenty-four patients in this series underwent posterior cervical plating with either an asymmetric (8), symmetric (9) or porte manteau (7) construct. Statistically significantly better results (P < 0.05) were achieved with either a symmetric or porte manteau construct. Complications including neurologic deficit and loss of correction were more frequent in the asymmetric group.

Adult↗
PubMed1992

[Stress fractures of the tarsal navicular. Apropos of 20 cases].

Twenty cases of tarsal navicular stress fractures were observed in 17 patients. These fractures are rare, often go unrecognized, and are reputed to unite with difficulty. A clue to diagnosis was given by the description (young athletic person in sports involving sudden starts and stops). The lesion was not always visible on X-rays of the foot in supination and dorsal flexion (only 10 out of 20 in this series). Use of tomography and tomodensitometry was essential. Treatment was based on compressing the fracture with a screw without grafting or freshening, followed by immobilization of the foot with a cast and no weight bearing for 45 days. Union occurred in 19 out of the 20 cases. Thirteen patients were able to practice their sport without a loss of performance after a period ranging from 3 to 14 months. Treatment varied given the risk of spontaneous non union: incomplete fractures discovered early often responded to orthopedic treatment; fractures associated with large intra-osseous lytic lesions required addition of bone grafting. These fractures can be prevented through the use of inner arch supports especially if a predisposing factor exists such as a short first metatarsal bone.

Adolescent↗
PubMed1991

[Achilles tendinitis].

Achilles tendinitis is particularly frequent in athletes. In fact, this entity is made up of various anatomical lesions located in Achilles tendon or at the point where it is attached to the calcaneum. The diagnosis is basically clinical, and it is confirmed by carefully selected paraclinical examinations. Management essentially relies on rest associated with adequate physiotherapy and, when required, with other adjuvant treatments. Management also rests on the prevention of recurrences and on the suppression of the frequently found sport-related causal agent. Surgical treatment is seldom indicated, and only when medical treatment has failed, usually in high-level athletes.

Achilles Tendon↗
PubMed1991

Symptomatic spinal epidural lipomatosis induced by a long-term steroid treatment. Review of the literature and report of two additional cases.

Spinal epidural lipomatosis associated with Cushing's syndrome is an uncommon complication (11 reported cases). Two additional symptomatic cases with neurologic deficit are described. Steroid treatment was systemic in the first case and local with epidural injections in the second. The second case is unique because no similar observations have yet been reported. In most cases, a preoperative computed tomographic scan establishes the diagnosis by demonstrating dural compression by an adipose mass. Myelography is far less specific. In some cases, the exact diagnosis is made at the time of surgery. The treatment is primarily surgical, with laminectomy over the length of the compression and the removal of the compressing fat. Neurologic recovery is dependent on two factors: the level of the compression and the adequacy of decompression.

Epidural Neoplasms↗
PubMed1991

[Old traumatic lesions of the dorsal and lumbar spine].

The authors present 71 cases of malunion or old traumatic lesions. They result from an unadapted initial surgical or functional treatment. The pain symptoms are in the form of vertebral pain or nerve root pain, often associated with signs of neurological deficit. The authors emphasize the stability or instability of the lesion in order to assess its reducibility. The radiographic exploration (dynamic views, MRI, CT, medullary arteriography) would serve as a guide for the treatment strategy. The authors do not report any case of permanent postoperative neurological aggravation. Three surgical options are analyzed (anterior approach, posterior approach and "three-stage" surgery). An enlarged posterior approach enables treatment and reduction of all malunions, except if a medullary feeder artery is present on the site of the lesion. The pain symptoms improve in 87% of all cases. The authors do not report any permanent postoperative neurological aggravation.

Adolescent↗
PubMed1991

[Severe multiple injuries. Strategy and results. Experience at the Hôpital de la Pitié in 1988 and 1989].

In our series of 97 patients with multiple in juries observed in 2 consecutive years (1988-1989), we have selected only the most severe injuries, of which the patients died within 48 hours, and those that required a long stay in the intensive care department. On admission, we recorded 49 cases of stage II or more severe coma, and 67% of patients under respiratory assistance with an instable hemodynamic state. Out of the 44 deaths recorded, 30 subjects were comatose from the beginning. The justifies the confrontation of 3 specialist teams in 2/3 of cases. The specific recruitment of the hospital and the selection of the most severe cases of these "people under a death sentence" for the study shows a heavy toll of mortality (45,4%), including 60% on the first day. The main cause of death is head injuries (81%). The multivisceral and infectious consequences of long-lasting, heavy intensive care and pulmonary or myocardial contusions account fort secondary deaths in 25% of the patients who had survived. Emergent neurosurgical operations are exceptional, but a neurosurgeon's opinion is always essential. Orthopedic surgical issues are not specific, but the frequency of spinal lesions must be emphasized (27,2%). In this series, 85% of the patients with multiple trauma presented with a lesion of the locomotive apparatus and underwent emergent surgery in every second case in satisfactory conditions. Severe thoracic and maxillofacial lesions requiring surgery are rare. Abdominal lesions are more frequent (17%) and must be dealt with in priority, but they rarely cause death. On the contrary, lesions to the major blood vessels and retroperitoneal compound lesions have a very poor prognosis.(ABSTRACT TRUNCATED AT 250 WORDS)

Emergencies↗
PubMed1991

[Surgical treatment of spinal metastases].

Spinal metastasis often lead to two main complications: back pain and para or tetraplegia. Performed alone radiotherapy may be too slowly efficient to allow a neurological recovery. Laminectomy may improve the neurological signs but does not induce any change on root pain and it increases instability. A surgical procedure by a posterior approach including laminectomy and fixation by plates and transpedicular screws fits these two goals: decompression and stabilisation. The first 189 cases are reported: the first month lethality is about 15%. 81% of fixations remained unchanged. 21 out of the 62 patients with loss of autonomy recovered an ability to walk. Besides this palliative surgery, a total spondylectomy has been done 13 times in order to perform a curative surgery for unique metastasis of cancers with long life expectancy. An early walking is often possible and after healing of the wound, a complementary treatment with radio or chemo therapy may be started without any risk of pain or neurological compression.

Adult↗
PubMed1991

[Treatment of complete lumbar disk herniation by percutaneous discectomy].

Percutaneous diskectomy is a new treatment used in surgery of the spine for the treatment of herniated lumbar disks. The idea is to carry out an exeresis with a posterolateral percutaneous approach on a part of the herniated intervertebral disk; while always remaining outside the spinal canal. This technique eliminates the risks of fibrosis or arachnoiditis. It is carried out under local anesthesia, reduces the surgical insult and requires only a short stay in hospital. Between 1984 and 1988, 188 operations using this technique were carried out on L3-L4, L4-L5 and L5-S1. Of the first 100 cases studied, we note: 71% good and very good results for radiculalgia after a time lapse of more than a year, 51% good and very good results for low back pain; 16% of the patients required a surgical approach after percutaneous diskectomy. The authors specify the advantages and the indications of this surgical technique, which complements the traditional lumbar intervertebral disk surgery.

Back Pain↗
PubMed1979

[Spherical osteotomy (author's transl)].

The authors have devised a new type of saw which makes it possible to cut bone spherically. This type of osteotomy is useful when correction is required in more than one plane and provides good bone contact between bone ends. The technique is described. It has been used at the upper end of the tibia or femur and in the calcaneus and forefoot.

Calcaneus↗