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PubMed1970

Synaptic connexions of alpha extensor motoneurones with ipsilateral and contralateral cutaneous nerves.

1. Synaptic responses of alpha extensor motoneurones to stimulation of cutaneous nerves of the hind limb were recorded from the lumbosacral region in decerebrate and decerebrate-spinal unanaesthetized cats. Responses to ipsi- and contralateral stimulation are compared.2. Usually a single volley in an ipsilateral cutaneous nerve led to an inhibitory post-synaptic potential while one in a contralateral cutaneous nerve led to an excitatory post-synaptic potential or to discharge of the cell, thus demonstrating the classical reciprocal innervation pattern. In some cells either ipsilateral or crossed spinal action was of opposite sign to normal.3. Tests using graded stimulation showed the range of myelinated afferents associated with crossed spinal actions to be narrower than that for ipsilateral actions; for the sural nerve the ranges are 1-6 mu and 1-9 mu respectively. A substantial proportion of the coarser myelinated afferents do not make connexion with alpha motoneurones on either side of the cord; in the sural nerve this proportion includes the range 10-17 mu.4. Central transmission times for ipsilateral and crossed-spinal actions were estimated after making systematic allowance for conduction time to the cord in the associated cutaneous afferents. Mean values for inhibitory pathways from ipsilateral cutaneous nerves were about 2 msec, while those for crossed spinal facilitatory pathways were notably greater, 3-5 msec.5. Crossed spinal actions were more profoundly depressed by anaesthesia than were corresponding ipsilateral actions.6. Interpretation of the results was aided by a separate study of the input to the spinal cord; stimulus strength is related to the diameters of the cutaneous fibres excited and to peripheral conduction time in those fibres.

Animals↗
PubMed2002

Apoptotic and proliferative markers in chordomas: a study of 26 tumors.

Few studies have examined the role of cell proliferation and apoptotic markers in chordomas. This study retrospectively reviews the clinicopathologic features of 26 chordomas and examines MIB-1, p53, bcl-2, and cyclin D1 immunoreactivity in these neoplasms. Patients ranged in age from 34 to 78 years (mean, 60.7 years) and included 14 females. The most common presentations included lower back pain (N = 15) and headaches (N = 10). Sixteen tumors arose in the lumbosacral region and 10 in the clivus. Initial surgery included biopsy (N = 17), subtotal resection (N = 4), and gross total resection (N = 5). The single highest mitosis count per 10 high power fields ranged from 0 to 6 (mean, 1). Marked nuclear pleomorphism was identified in seven tumors. Marked hypercellularity was seen in two tumors. Focal necrosis was identified in seven tumors. MIB-1 labeling indices (LI) in 22 tumors ranged from 0 to 3.8 (mean, 0.5). Cyclin D1 LI ranged from 0 to 82.4 (mean, 35.6). Seven tumors had positive p53 immunostaining and three demonstrated focal positive staining with bcl-2 antibody. Five tumors locally recurred; two patients developed metastatic disease. Thirteen patients received adjuvant chemotherapy and/or radiation therapy. At last known follow-up, seven patients died with tumor (12 to 132 months follow-up). Five additional patients died, two without tumor at 36 and 72 months follow-up and three patients in whom the tumor status at death was not known. Seven patients were alive with evidence of tumor (1 to 120 months) and five patients were alive without evidence of tumor (12 to 84 months). Clinical follow-up was not available in one patient. In conclusion, the low MIB-1 LIs and the lack of p53 and bcl-2 staining is in keeping with the low-grade nature of most chordomas. High cyclin D1 LIs may be reflective of a tendency to accumulate cyclin D1 protein; however, there appears to be a block in the effect of cyclin D1 on cell proliferation in these tumors. Cyclin D1, MIB-1, p53, and bcl-2 immunostaining does not appear to improve one's ability to predict behavior versus routine light microscopy.

Adult↗
PubMed2003

Comparison of three lumbar orthoses using motion assessment during task performance.

STUDY DESIGN: Four conditions (three orthoses, one no orthosis), full cross-over, randomized order, 12 subjects tested 3 months after a lumbar surgical arthrodesis. OBJECTIVES: To assess whole torso and lumbar motions and comfort for each orthoses condition during performance of activities of daily living. SUMMARY OF BACKGROUND DATA: Previous noninvasive studies measured whole torso (not just lumbar) movement. Recent development of a low profile, flexible, strain-gauged device ("Lordosimeter") facilitated this study. MATERIALS AND METHODS: The Lordosimeter was taped to the skin along the midline of the lumbosacral region. Orthoses studied were Boston anterior opening, Aspen lumbosacral, and Cybertech. Specified activities of daily living were performed for each orthosis condition. Subject effort during the flexion/extension task was assessed by surface electromyography (EMG). Comfort was assessed by visual analog scale. RESULTS: There were no significant differences in EMG between orthoses. For lumbar flexion, trunk flexion, total lumbar motion, and total trunk motion, the mean values for Aspen and Boston (but not Cybertech) were significantly smaller than for no orthosis for most of the tasks and there were no significant differences between Aspen and Boston. The total lumbar motion allowed by each orthosis (averaged across tasks and relative to the no orthosis condition) was 81% for Aspen, 79% for Boston, and 97% for Cybertech. The comfort rating averaged across tasks was 2.24 for Aspen, 4.12 for Boston, and 3.92 for Cybertech (0 = very comfortable, 10 = very uncomfortable). Aspen was significantly more comfortable than Boston or Cybertech. Boston and Cybertech did not differ significantly. CONCLUSIONS: The Lordosimeter is useful for measuring lumbar motion during orthosis wear. The Aspen and the Boston orthoses provided significant flexion-extension motion restriction compared with no orthosis, but for almost all of the motion measures did not differ from each other. The Cybertech did not differ significantly from the no orthosis condition. The Aspen orthosis was rated significantly more comfortable than the Boston or the Cybertech.

Activities of Daily Living↗
PubMed1992

Transient expression of GABA immunoreactivity in the developing rat spinal cord.

The development of GABAergic neurons in the spinal cord of the rat has been investigated by immunocytochemical staining of frozen sections with anti-gamma-aminobutyric acid (GABA) antiserum. In the cervical cord, GABA-immunoreactive fibers first appeared at embryonic day (E) 13 in the presumptive white matter within the ventral commissure, ventral funiculus, and dorsal root entrance zone, and in the ventral roots. There were no GABA-immunoreactive cell bodies detected at this age. By E14, motoneurons, the earliest generated spinal cells, were the first cell population to become GABA-immunoreactive at the cell body level. Thereafter, GABA-immunoreactive neurons increased progressively in number and extended from ventral to dorsal regions. GABA-immunoreactive relay neurons within lamina I of the dorsal horn were initially detected at E17. Interneurons in the substantia gelatinosa, the latest generated cells in the spinal cord, were also the last to express the GABA immunoreactivity at E18. Immunoreactive neurons peaked in intensity and extent at E18 and 19. GABA immunoreactivity was only detectable in neurons within the intermediate and marginal zones 1-3 days after they withdrew from the cell cycle. This contrasts to glutamate decarboxylase immunoreactivity, which is detected in precursor cells in the ventricular zone prior to, or during, withdrawal from the cell cycle. Toward the end of gestation, GABA immunoreactivity declined in intensity and extent. This regression began in the ventral horn of the cervical region and ended in the dorsal horn of the lumbosacral region. During the first week after birth, immunoreactivity in motoneurons and in many other neurons within the ventral horn, intermediate gray, and deeper layers of the dorsal horn disappeared, and only in those neurons predominantly within the superficial layers of the dorsal horn did it persist into adulthood. Thus, the expression and regression of GABA immunoreactivity in the spinal cord followed ventral-to-dorsal, rostral-to-caudal, and medial-to-lateral gradients. These observations indicate that the majority of embryonic spinal neurons pass through a stage of transient expression of GABA immunoreactivity. The functional significance of this transient expression is unknown, but it coincides with the period of intense neurite growth of motoneurons, sensory neurons, and interneurons, and of neuromuscular junction formation, suggesting that the transient presence of GABA may play an important role in the differentiation of sensorimotor neuronal circuits.

Animals↗
PubMed1997

Pattern of malformations in the axial skeleton in human trisomy 21 fetuses.

In the present study, we analyzed the development of the axial skeleton in human trisomy 21 fetuses and defined the fields in the axial skeleton affected in this form of aneuploidy. We investigated 31 human fetuses with trisomy 21, gestational ages 12-24 weeks, on the basis of radiographs of midsagittal tissue blocks of the axial skeleton, comprising the cranial base and the spine. Malformation or agenesis of the nasal bone was present in 19 of 31 fetuses. Nineteen cases had vertebral malformations. Fourteen fetuses had malformations in the cervical region, four in the thoracic and eight in the lumbosacral region. In 1 of 31 fetuses, malformation was seen in the basilar part of the occipital bone. The basisphenoid component appeared scallop-shaped in 30 cases. The pattern of axial skeletal malformations in trisomy 21 fetuses recorded here has not been described previously. Comparison is made with our recent study of trisomy 18, where the pattern of axial skeletal malformations was quite different. It is recommended that axial skeletal radiography should be part of the autopsy of fetuses where chromosome abnormalities are known or suspected.

Bone and Bones↗
PubMed1993

A comparison of pressure pain thresholds in different tissues and body regions. Long-term reliability of pressure algometry in healthy volunteers.

Pressure pain thresholds (PPTs) were measured in 12 healthy female volunteers with a hand-held electronic pressure algometer (Somedic). The PPTs over 30 points, mainly located on the trunk, were measured in a randomized order. The measurements were repeated after one week and again 10-13 weeks later. Three spots over nerve tissue had lower PPTs than nearby muscle. There were no consistent differences between muscle and periosteum within the same region. Overall there was a tendency for points in the nape region to have the lowest PPT, and those in the lumbosacral region to have the highest. The shoulder points had intermediate values. The interindividual differences were great. There was no difference between the mean PPTs from the first session and those from the second session. However, at the third session, 10 weeks later, the average PPT value was substantially higher than in the previous sessions.

Adolescent↗
PubMed2000

The iliolumbar ligament: three-dimensional volume imaging and computer reformatting by magnetic resonance: a technical note.

STUDY DESIGN: An assessment of magnetic resonance imaging techniques of the iliolumbar ligament. OBJECTIVES: To identify a technique to better image the iliolumbar ligament. SUMMARY OF BACKGROUND DATA: The iliolumbar ligament plays an important role in providing lumbosacral stability. Two-dimensional magnetic resonance imaging of the lumbar spine only provides a fragmented representation of the ligament. METHODS: A two-part study was performed. In the first part, three cadaver pelvi were dissected, and the individual bands of the iliolumbar ligament were identified. Computer reformatting of magnetic resonance three-dimensional volume images then were performed, correlating the structural characteristics of the iliolumbar ligament to its magnetic resonance image. In the second part of the study, the lumbosacral region of three groups of patients were evaluated. Group I was studied with routine magnetic resonance imaging techniques of the intervertebral disc regions. Group II was studied with routine contiguous axial magnetic resonance imaging of the lumbosacral spine. Group III was studied with computer reformatting of three-dimensional volume images of the lumbosacral spine. RESULTS: Accurate imaging of the iliolumbar ligament of cadaver specimens was achieved with three-dimensional volume imaging and computer reformatting. Routine imaging of the intervertebral disc region as well as contiguous axial imaging of the spine depicted only limited segments of the iliolumbar ligament. Three-dimensional volume imaging and computer reformatting allowed precise imaging of the iliolumbar ligament in all patients, demonstrating the ligament orientation as well as length, width, and depth. CONCLUSION: Only images of the iliolumbar ligament obtained through computer reformatting of three-dimensional volume averaging from L3 to the sacral ala correlated with the ligament's structural characteristics.

Adult↗
PubMed2003

Surgical management of lumbosacral nerve root hemangioblastomas in von Hippel-Lindau syndrome.

OBJECT: Hemangioblastomas in the lumbosacral region are rare, and the authors of prior reports have not defined the surgical management, histopathological features, or outcome in a group of patients after resection of these tumors. To identify features that will help guide the operative and clinical management of these lesions, the authors reviewed data obtained in a series of patients with von Hippel-Lindau syndrome who underwent resection of lumbosacral nerve root hemangioblastomas. METHODS: Six consecutive patients (three men and three women; mean age at surgery 39 years [range 31-48 years]) who underwent operations for resection of lumbosacral nerve root hemangioblastomas were included in this study. The mean follow-up period was 23 months (range 6-45 months). Data derived from examination, hospital charts, operative findings, histopathological analysis, and magnetic resonance imaging were used to analyze surgical management and clinical outcome. The resected tumors were located in the lumbar (five cases) or sacral (one case) regions; the mean tumor size was 2728 mm3 (range 80-15,022 mm3). Consistent with central nervous system (CNS) regional variation of space available to accommodate the neural compressive effect of the hemangioblastoma size, the mean tumor volume (2728 mm3) of these symptomatic lesions was much larger than that of symptomatic hemangioblastomas resected in the other regions of the CNS. Histopathological examination showed infiltration of the associated nerve root by the hemangioblastoma in each case. In five of the six patients complete resection was achieved, and in one patient intradural exploration of two hemangioblastomas was performed, but resection was not achieved because of motor root involvement. In all cases involving complete resections the patients experienced symptomatic improvement. CONCLUSIONS: Lumbosacral nerve root hemangioblastomas can be safely removed in most patients with von Hippel-Lindau syndrome. Generally, hemangioblastomas of the lumbosacral nerve roots should be resected when they become symptomatic. Because these neoplasms appear to originate from the nerve root, it is necessary to sacrifice the nerve root from which the hemangioblastoma originates to achieve complete resection.

Adult↗
PubMed1993

Effects of chronic morphine treatment on beta-endorphin-related peptides in the caudal medulla and spinal cord.

The effects of chronic morphine treatment on beta-endorphin (beta E)-immunoreactive (beta E-ir) peptide levels were determined in the rat caudal medulla and different areas of the spinal cord. Seven days of morphine pelleting had no effect on total beta E-ir peptides in the caudal medulla. In contrast, it significantly increased beta E-ir peptide concentrations in the cervical and thoracic regions of the spinal cord compared with placebo-pelleted controls, whereas in the lumbosacral region this trend did not reach statistical significance. Injections of the opiate receptor antagonist naloxone 1 h before the rats were killed had no effect on the morphine-induced increases in the cord. Chromatographic analyses revealed that enzymatic processing of beta E-related peptides in the spinal cord seemed unaffected by the morphine and/or naloxone treatments. In light of previous data showing that morphine down-regulates beta E biosynthesis in the hypothalamus, the present results suggest that the regulation of beta E-ir peptides in the spinal cord is distinct from that found in other CNS areas. These data provide support for previous results suggesting that beta E-expressing neurons may be intrinsic to the spinal cord.

Animals↗
PubMed1990

Development of the rat corticospinal tract through an altered glial environment.

The major corticospinal tract (CST) in the rat is located at the base of the dorsal funiculus. It is a late-developing tract, and the growth of its axons into the lumbosacral region of the spinal cord does not occur until postnatal days 5 and 6. This delay is taken advantage of in this study in order to evaluate the effects of a markedly reduced glial population on ingrowth of the CST axons into the lumbosacral spinal cord. A reduction of the glial population is achieved by exposure of this region of spinal cord to X-radiation at 3 days of age. Growth of CST axons into and through the lumbosacral spinal cord in rats in which this region has undergone a radiation-induced depletion of glial cells is compared with that in their non-irradiated littermate controls by axonal tracing techniques using horseradish peroxidase (HRP). The HRP was applied directly to the motor cortices of normal and irradiated rats, and at all ages studied, there was anterograde filling of CST axons and their growth cones. At 3 days postnatally, the age when the lumbosacral spinal cord was irradiated in the experimental animals, CST axons were present in the more rostral thoracic levels. CST axons were observed in the lumbar region of non-irradiated rats on day 5, and by day 7 they were present at sacral levels.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed2003

Lumbar end plate osteotomy in adult patients with scoliosis.

The maintenance of mobile segments in the lumbar spine may prevent complications associated with long fusions to the sacrum and permit improved postoperative patient function and mobility. The purpose of the current study was to describe the technique of end plate osteotomy for surgical treatment of fractional curves in the lumbosacral region. This technique serves to allow the end lumbar vertebra to become horizontal, to reduce lumbosacral fractional curves, and to create a stable end vertebra above the pelvis. A review of long-term clinical and radiographic outcomes in patients treated with the technique have been satisfactory. The authors show that the techniques of end plate osteotomy with concave osteophyte excision is a clinically valuable technique for the treatment of adults with fixed lumbosacral fractional curves.

Adult↗
PubMed2001

Histochemical and immunocytochemical investigations of the marginal nuclei in the spinal cord of pigeons (Columba livia).

In birds there are segmentally organized marginal nuclei at the lateral or ventrolateral border of the spinal cord. In most regions of the spinal cord these nuclei are within the outline of the cord. However, in the lumbosacral region they form accessory lobes protruding into the vertebral canal. Histochemical and immunocytochemical investigations were performed to study the neurochemical features of the marginal nuclei of the pigeon. Despite histological differences (only accessory lobe neurons are embedded in glia-derived glycogen cells), there was no difference in the chemical neuroanatomy of the two types of marginal nuclei. These nuclei contained cholinergic neurons and there was also evidence for a cholinergic innervation. NADPH-diaphorase activity, which is considered to indicate nitric oxide synthesis, was faint in marginal neurons. No serotonin immunoreactivity was found. However, all neurons showed immunoreactivity to glutamate and glycine, and some were immunoreactive to gamma-aminobutyric acid (GABA). A GABAergic innervation of non-GABAergic neurons could also be demonstrated. The lack of difference in the chemical neuroanatomical features between cervical marginal nuclei and lumbosacral accessory lobes suggests a similar origin of all marginal neurons. A comparison with the chemical neuroanatomy of marginal neurons in other vertebrates shows both similarities and differences.

Acetylcholinesterase↗
PubMed1998

Assessment of lumbosacral fusion mass by angled radiography. Technical notes.

STUDY DESIGN: Lumbosacral fusion masses were assessed by angled radiography. OBJECTIVES: To introduce the use of the angled anteroposterior radiograph in the evaluation of the fusion mass at the lumbosacral region. SUMMARY OF BACKGROUND DATA: Determination of the presence and progress of the fusion mass at the lumbosacral junction may be difficult clinically and radiologically. Few studies regarding the use of the angled anteroposterior view of plain radiographs in evaluating L5-S1 fusion are available. METHODS: The patient was placed in the supine position, and an angled view of the lumbosacral junction was obtained. Radiography of the angled anteroposterior view was performed with the x-ray beam oriented toward the cranial portion at 50 degrees to 55 degrees relative to the x-ray table. RESULTS: The use of the angled view of the lumbosacral junction eliminates the superimposition of the L5 transverse process on the posterior part of the superior ala of the sacrum, widens the L5-S1 intertransverse space, and enhances direct visualization. CONCLUSIONS: The use of the angled anteroposterior view on plain radiographs is recommended in the evaluation of the fusion status at L5-S1.

Arthrography↗
PubMedDate not supplied

[The comparative effect of classic massage of different intensities on patients with chronic salpingo-oophoritis].

Massotherapy in different regimens has been used in 30 patients in remission of chronic salpingo-oophoritis (CSO). The massage produced positive changes in blood coagulation, immune status, regional hemodynamics of the small pelvis, bioelectric activity of the muscles of the anterior abdominal wall and lumbosacral region. A strong anesthetic and antiinflammatory effect of intensive massage in 78%, recovered reproductive function in 33% of the patients allow to recommend intensive massage as possible monotherapy of patients in remission of CSO.

Adult↗