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S J Lipson

Publications and source records attributed to S J Lipson.

17 recordsLinked to original sources
PubMed1992

Stevens-Johnson-type reaction with vancomycin treatment.

OBJECTIVE: To report a case of Stevens-Johnson syndrome caused by vancomycin. CASE SUMMARY: Stevens-Johnson syndrome is an acute mucocutaneous process characterized by epidermal and mucosal desquamation. Its pathogenesis is poorly understood. Mortality rates have ranged from 30 to 100 percent. We describe a case of Stevens-Johnson syndrome related to the use of vancomycin in a 71-year-old woman with rheumatoid arthritis receiving treatment for an infected cervical fusion site. Classic "target" lesions distributed throughout the trunk and extremities along with erosive lesions involving the oral and vaginal mucosae were observed in this patient. DISCUSSION: A number of agents have been implicated in the etiology of Stevens-Johnson syndrome. Serious cutaneous reactions to vancomycin, however, have been uncommon. Cessation of vancomycin treatment in our patient led to eventual resolution of her symptoms. CONCLUSIONS: Vancomycin is a potential causative agent of Stevens-Johnson syndrome.

Aged↗
PubMed1991

The outcome of decompressive laminectomy for degenerative lumbar stenosis.

The outcome of laminectomy for the relief of symptoms resulting from degenerative lumbar stenosis is not well established. Eighty-eight consecutive patients who had had a laminectomy for degenerative lumbar stenosis between 1983 and 1986 were studied. Eight of the patients had had a concomitant arthrodesis. The follow-up evaluation included a review of charts and standardized questionnaires that were completed by the patients. One year postoperatively, five patients (6 per cent) had had a second operation and five still had severe pain. By the time of the latest follow-up, in 1989, fifteen (17 per cent) of the original eighty-eight patients had had a repeat operation because of instability or stenosis; twenty-one (30 per cent) of the seventy patients who were evaluated by questionnaire in 1989 had severe pain. The factors found to be associated with a poor long-term outcome, defined as severe pain or the need for a repeat operation, or both, included co-existing illnesses (such as osteoarthrosis, cardiac disease, rheumatoid arthritis, or chronic pulmonary disease) (p = 0.004), the duration of follow-up (p = 0.01), and an initial laminectomy involving a single interspace (p = 0.04). We concluded that the long-term outcome of decompressive laminectomy is less favorable than has been previously reported, and that co-morbidity and a single-interspace laminectomy are risk factors for a poor outcome.

Aged↗
PubMed1989

Rheumatoid arthritis in the cervical spine.

Rheumatoid arthritis causes synovitis in the cervical spine and injures skeletal structures at any level. Subluxations occur with pain and spinal cord dysfunction. Subluxations are common; neurological problems are less so, but death from subluxations is not common. However, once myelopathy is established, the natural history is poor. Advances in radiologic imaging through computed tomography and magnetic resonance imaging greatly assist anatomic assessment. Neurologic deterioration and pain are indications for surgery. Preoperative skeletal traction is often required to align the spine, and fusion techniques are used for stabilization.

Arthritis, Rheumatoid↗
PubMed1988

Metaplastic proliferative fibrocartilage as an alternative concept to herniated intervertebral disc.

It is hypothesized on the basis of experimental intervertebral disc degeneration that herniated disc is actually newly synthesized proliferative metaplastic fibrocartilage and not herniation of pre-existing disc tissue, particularly that of the nucleus pulposus. Human material in selected surgical tissues was examined to test this concept. Histology revealed evidence for proliferative fronts of fibroblastic cells in herniated discs with hypocellular interiors. Hydroxypyridinium cross-link assay was used to determine the maturity of the collagen. Results indicated, with statistical significance, that herniated disc is a younger tissue than in situ annulus fibrosis, and that herniated disc is not from the nucleus pulposus, thus supporting the hypothesis.

Adult↗
PubMed1988

Spinal stenosis.

Degenerative spinal stenosis is the most common type of stenosis encountered, often presenting with neurogenic claudication. History and physical examination indicate its presence and radiologic imaging is used to demonstrate the spatial reduction in the lumbar canals. Nonoperative therapy can be effective while surgical decompression offers the most reliable and definitive therapeutic intervention.

Humans↗
PubMed1985

Cervical myelopathy and posterior atlanto-axial subluxation in patients with rheumatoid arthritis.

Posterior atlanto-axial subluxation, which is uncommon and usually is considered a benign condition, was associated with cervical myelopathy in four patients with rheumatoid arthritis. The cause of the myelopathy appeared to be posterior kinking of the spinal cord without demonstrable compression. Contrast-enhanced sagittal imaging or computerized tomographic sagittal reconstruction provided the best means of demonstrating the abnormal configuration of the spinal cord. Halo traction and occipitocervical fusion yielded satisfactory results in all four patients after follow-up of one to two years. We developed a method to provide rigid fixation of an occipitocervical fusion in which a corticocancellous iliac-bone graft was backed with metal mesh, wired in place, and reinforced with methacrylate.

Aged↗
PubMed1984

Computed tomography of aneurysmal bone cyst of the L1 vertebral body.

A 31-year-old woman with an aneurysmal bone cyst of the L1 vertebral body proved by biopsy and studied by plain lumbar spine roentgenography, radionuclide studies, myelography, and CT is presented. The unusual location of involvement of the vertebral body alone and the difficulty in differential diagnosis between aneurysmal bone cyst and benign giant cell tumor are discussed.

Adult↗
PubMed1977

Dysplasia of the odontoid process in Morquio's syndrome causing quadriparesis.

Eleven patients with documented Morquio's syndrome who had dysplasia of the odontoid process and resulting atlanto-axial instability were reviewed. They were found to be at risk for acute traumatic quadriparesis, chronic myelopathy of a variable and often rapid rate of progression, and sudden death by respiratory arrest. The evidence suggests that early prophylactic posterior cervical fusion is indicated for patients with this malformation and that once quadriparesis is established, recovery of function is limited.

Adult↗
PubMedDate not supplied

Atlantoaxial arthrodesis in the presence of posterior spondyloschisis (bifid arch) of the atlas. A report of three cases and an evaluation of alternative wiring techniques by computerized tomography.

The presence of a bifid posterior arch of the atlas has been regarded as a contraindication to the wiring of C1-2 for atlantoaxial arthrodesis. Three cases with C1 posterior spondyloschisis are presented with successful atlantoaxial arthrodesis using laterally placed wires to avoid the midline defect of the atlas. An experimental study of the efficacy of three different wiring constructs by computerized tomography showed that there is little difference between midline versus lateral wiring in restricting rotation of C1-2.

Adult↗
PubMedDate not supplied

Rheumatoid arthritis of the cervical spine.

The synovitis of rheumatoid arthritis (RA) injures structures in the cervical spine, allowing atlantoaxial subluxation, atlantoaxial impaction, and subaxial subluxation. Spinal cord and vertebral artery injury can ensue. Subluxations are common, but neurologic abnormalities are less so. Patients with RA can die from subluxations but usually do not, although many become worse with time. Nonsurgical management is supportive and designed to lessen pain. Neurologic abnormality is the major indication for surgery. Preoperative skeletal traction is often needed. Posterior fusion is most commonly done for stabilization.

Arthritis, Rheumatoid↗