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Biomedical subjects

S Eisenstein

Publications and source records attributed to S Eisenstein.

At least 19 recordsLinked to original sources
PubMed2005

Admiral Lord Nelson's death: known and unknown--a historical review of the anatomy.

STUDY DESIGN: Reviewing documents about Lord Admiral Nelson's wound inflicted at the Battle of Trafalgar and studying the collected data in connection with ballistics and human anatomy. OBJECTIVES: Attempting to find out the actual cause of death of Lord Nelson as soon as 4 h postinjury by a musket ball. SETTING: United Kingdom. METHODS: (1) Review of the original report of Mr W Beatty, Lord Nelson's surgeon, on his examination of His Lordship's wound. (2) Investigating the course of the musket ball in connection with an atlas of human anatomy. (3) Investigating the course of the musket ball on a cadaver by RP (one of the authors). (4) Reviewing modern medical literature. RESULTS: The report of Mr Beatty suggested that division of a large branch of the pulmonary artery was the cause of Lord Nelson's early death. Assuming the left pulmonary artery was injured, anatomical studies based on atlases and dissection on a cadaver failed to support a simple straight-line course of the musket ball that could have divided the artery and damage the spinal cord on its path forward. CONCLUSION: The question remains open as to how the musket ball following a relatively straight-line trajectory by entering the body at the acromion, could have divided the left pulmonary artery and damaged the spinal cord later in its course. The mechanism needs further investigation.

Blood Vessels↗
PubMed1997

The one bone spine: a failure of notochord/sclerotome signalling?

Three cases of extensive vertebral fusions with absent clivo-axial angle are presented. The 'bone-within-bone' appearance in two patients with almost complete fusion of the spine suggested ossification of the notochord and perinotochordal sheath. On the basis of the radiological appearances and the results of recent molecular genetic studies on vertebrate embryos, the suggested time of segmentation failure along the axis of the craniovertebral junction and between vertebrae is the third to fifth week of gestation. The possible roles of the Pax-1 gene and of signalling between notochord and sclerotome are discussed, concluding that an early defect of the notochord may be responsible for this type of failure of segmentation. Indications for surgery in these cases included cord compression with brachialgia and 'chin-on-chest' deformity causing severely restricted visual fields. A critical review of clinical lessons learned in the operative treatment is presented.

Adult↗
PubMed1992

Closing wedge osteotomy with transpedicular fixation in ankylosing spondylitis.

The Smith-Petersen anterior opening wedge osteotomy of the lumbar spine is currently the accepted technique for the correction of spinal deformity in ankylosing spondylitis. It has a mortality of 10%, uses force, is uncontrolled, and fixation is often feeble. The authors have devised a posterior closing wedge with transpedicular fixation. This technique is controlled, comparatively safe, and provides secure fixation. The procedure is a relatively safe and reliable means of dealing with a dangerous operation.

Adult↗
PubMed1989

Segmental spinal instrumentation using short closed wire loops.

The Luque technique of segmental sublaminar instrumentation is now an established method of internal fixation in spinal surgery. The major difficulty encountered with the current technique is the danger of neurologic injury during the passage and handling of conventional wires, especially in extensive procedures. Great care is required to prevent inadvertent percussion of the wires already passed. The authors believe that by using short closed wire loops, these dangers have been minimized. Simple additional instrumentation has been devised to facilitate application of these loops. Apart from ease of application and handling, the short wire loops may offer a safer method of segmental sublaminar fixation.

Adolescent↗
PubMed1988

Painful scoliosis secondary to an osteoid osteoma of the rib.

A 14-year-old girl with painful scoliosis was found to have an osteoid osteoma involving the body of the left seventh rib. Excision of the tumor was facilitated by intraoperative bone scanning that precisely located its position. Following surgery, preoperative pain was completely relieved and the spinal curvature had partially regressed. The importance of early diagnosis and excision of tumors is emphasized to prevent the establishment of a permanent structural scoliosis.

Adolescent↗
PubMed1983

Lumbar vertebral canal morphometry for computerised tomography in spinal stenosis.

Computerised tomography is described in recent literature as a sophisticated but noninvasive technique with a particularly appropriate application in the discovery of space-occupying lesions in the lumbar vertebral canal and nerve root tunnels. Although the spinal stenosis syndrome must remain a clinical diagnosis in the first instance, computerised tomography is expected to play an increasing role in confirming the presumptive diagnosis of developmental or degenerative spinal stenosis, and in confirming the presence of a trefoil configuration or narrow lateral recess. However, the diagnosis of spinal stenosis on computerised tomography is impossible unless dimensions can be compared with established ranges of normal. The morphometry of a large sample of human skeletons of both sexes, in two race groups, and for each of the five lumbar vertebral levels, is intended to provide this information.

Ethnicity↗
PubMed1980

The trefoil configuration of the lumbar vertebral canal. A study of South African skeletal material.

The shallow lateral recesses of the trefoil shape of the lumbar spinal canal have been implicated in the production of the spinal stenosis syndrome. In the present study, 485 skeletons of South African Blacks and Whites were examined in order to establish the incidence and possible genesis of the trefoil configuration. The overall incidence was 14 per cent, with little variation between the sexes or races. The incidence was not related to increasing age, measured stenosis of the spinal canal or osteophytosis. Of 74 trefoil-shaped vertebrae, 68 (92 per cent) were found at the fifth lumbar level. It is suggested that the trefoil configuration is a common non-pathological condition, usually of the fifth lumbar vertebral canal, and is probably a developmental variation of normal anatomy.

Black or African American↗
PubMed1978

Spondylolysis. A skeletal investigation of two population groups.

The lumbar spines of 485 skeletons of adult South African "Whites" and "Blacks" of both sexes were examined to determine the incidence and morphology of defects in the pars interarticularis. The overall incidence was 3.5%, without significant variation between races and sexes. The incidence of lumbar spina bifida in the whole sample was 1.9%, but was 11.8% in those skeletons with spondylolysis. Some instances of unilateral spondylolysis demonstrated obvious callus formation, suggesting a capability for normal repair. It is possible that the defects in bilateral cases represent established non-union of fractures of the pars interarticularis resulting from excessive mobility, and are not due to dysplasia of bone. It is noted, for the first time, that the superior facets of affected vertebrae are abnormally enlarged, and that the inferior facets of the separate neural arch are characteristically elliptical.

Adult↗
PubMed1977

Chylothorax: a complication of Dwyer's anterior instrumentation.

The authors report the development of an extensive right chylothorax several days after Dwyer's anterior instrumentation in a 6-year-old girl with a severe progressing infantile scoliosis. Instrumentation extended from T11 to L4 with removal of the tenth rib and with splitting of the diaphragm. The postoperative course was initially without any problems. However, respiratory distress on the tenth day after surgery was accompanied by mediastinal shift and the symptoms were relieved with aspiration of 600 ml of chyle from the right pleural cavity. The literature on this complication of chylothorax is reviewed; it has been observed in cardiothoracic surgery. The management of the case is reported in detail and methods of detection and treatment are discussed.

Child↗
PubMed1977

The morphometry and pathological anatomy of the lumbar spine in South African negroes and caucasoids with specific reference to spinal stenosis.

Direct measurements were made on 2,166 lumbar vertebrae of 433 adult negro and caucasoid skeletons. On statistical analysis, forty-five vertebrae in twenty-seven skeletons were found to be stenotic, the mid-sagittal diameter being the significantly reduced dimension. Whereas spinal stenosis syndromes are rare in South African negroes, the lumbar canal is marginally narrower in the negro. There is a uniformity of configuration and capacity of the lumbar spinal canal, which transcends race and sex. By a new method of determining the dorsal limit of the lumbar canal on lateral plain radiography, the overall average lower limit of normal of the mid-sagittal diameter is established at 15 millimetres, and of the transverse diameter 20 millimetres. Bony degenerative changes are more likely to cause neurological compression in the nerve root tunnel than in the spinal canal. The role of skeletal narrowing of the spinal canal as an exclusive cause of the spinal stenosis syndrome may have been exaggerated.

Adolescent↗