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At least 739 records · Page 41Linked to original sources
PubMed1988

[Diagnosis and surgical strategy in 3 cases of benign and unusual tumors of the occipito-cervical skeleton].

The authors report three cases of benign tumours of the occipito-cervical skeleton, remarkable for their rarity and especially by their unusual, even exceptional anatomic site: an osteoid osteoma, a pre-medullary chondroma and an extra-dural exostosis developing within a hereditary multiple disease. This presentation which allows to recall a few epidemiological and diagnostic problems is essentially focused on operative strategy and particularly on the choice of the best way to cope with surgical difficulties to be met. The osteoid osteoma whose diagnosis is difficult raises two surgical problems: the relation with the vertebral artery and the preservation of the atlanto-occipital joint. An approach through limited occipital craniotomy has allowed a perfect control of the vertebral artery and a complete removal without joint damage. Pre-medullary chondroma: a complete removal has been performed through the anterior way as described in rare observations of the literature. Post operatively, the patient had a complete neuro-orthopedic recovery. The antero-lateral exostosis has been removed through the posterior way by first resecting the basis of implantation, which has allowed the mobilization of the lesion without cord damage. Results have been good in the three cases both from neurological and orthopedic points of view.

Adult↗
PubMed1988

[180 degree versus 360 degree rotation in SPECT of bone].

Opinions differ as to the advantages of the 180 degrees and the 360 degrees techniques concerning myocardial scintigraphy with 201Tl. Following our own encouraging experiences with the 180 degrees technique, we have looked for cases in bone scintigraphy where reconstructions from a semicircle could be advantageous over a full circle reconstruction. There were metastases and foci of osteomyelitis in spine, ribs and skull (especially in the skull base), to be seen better in reconstructions using images out of 180 degrees close to the object. In knee SPECT a closer radius of rotation can be chosen with single-head cameras so that, when using the 180 degrees technique, a better reproduction of the anatomical structures and pathological alterations is achieved.

Adult↗
PubMed1988

Imaging strategies for MR of the spine.

Magnetic resonance (MR) imaging has rapidly evolved as a primary modality for evaluating the spine. Following routine radiographs, MR is currently the preferred examination in evaluating patients presenting with myelopathy, suspected congenital abnormalities, discitis/osteomyelitis, and myeloradiculopathy. It is becoming the examination of choice in evaluating patients with radiculopathy as well when fast-scan techniques are available. MR of the spine will prove increasingly important as the technology advances. It is likely that MR will replace myelography entirely for many indications.

Humans↗
PubMed1988

[Diagnosis and treatment of sacral and retrorectal tumors. II].

Forty-three sacral and retrorectal tumors encountered at the Cleveland Clinic were reviewed, with emphasis on incidence, diagnosis, and management. Benign tumors could be differentiated from malignant lesions on the basis of history, physical examination, and radiologic studies. CT scan and Magnetic Resonance Imaging are the most useful tests for staging. Small benign tumors may be removed through a posterior approach. All malignant lesions, and benign lesions greater than 3-4 cm in size should be removed through a combined anterior and posterior approach. All tumors should be completely removed wherever possible, since both benign and malignant tumors will recur when excision is incomplete. Radiotherapy and chemotherapy may provide some palliation for malignant tumors, but these modalities are not curative in our experience.

Adult↗
PubMed1988

Anterior decompression and stabilization of the spine as a treatment for vertebral collapse and spinal cord compression from metastatic malignancy.

During a ten-year period, 77 patients with spinal instability caused by metastatic pathologic fractures of one or more vertebrae were treated with anterior decompression and stabilization by replacement of the affected vertebral bodies with methylmethacrylate, polymerizing in situ, augmented by Knodt distraction rods positioned anteriorly. No postoperative external support was required, and the fixation achieved by this method was not affected adversely by subsequent irradiation at a mean of 4020 rads. Sixty-two patients had major neurologic impairments preoperatively and required spinal cord and/or nerve root decompression anteriorly prior to fixation. Of these, 26 had complete neurologic recovery postoperatively, 16 others improved significantly, 20 remained unchanged, and one patient deteriorated neurologically. Five patients suffered failures of fixation, although two were successfully restabilized after a second operation. The remaining 72 patients enjoyed good or excellent resolution of spine pain postoperatively, and, in patients surviving their underlying malignancies, stability did not deteriorate during the follow-up period ranging from 42 to 146 months. Six patients developed spinal instability from tumor lysis at a different level between five and 95 months postoperatively. All were treated with successful decompression and stabilization. There was one wound infection among the 83 anterior stabilization procedures. However, three of the six patients requiring secondary posterior stabilization suffered wound dehiscences, and three of these became infected.

Adult↗
PubMed1987

Laminectomy or laminotomy?

After laminectomy in infants and children vertebral deformities often develop. To prevent these the author applied the reanchoring of the dissected arches and ligaments (laminotomy) with success in four children. The details of the procedure and the reanchoring of the vertebral arches are described. This treatment modality should be favourized instead of the destructive laminectomy in this age group in the majority of cases.

Astrocytoma↗
PubMed1987

Therapy for advanced thyroid cancer: treatment of a high risk case.

The treatment of a high risk case of an advanced thyroid cancer is reported. The patient had a thyroid cancer with metastatic lesions of the frontal bone, left temporal bone, left sacroiliac joint, lytic destruction of C6 and lytic lesion of C7. A pre-operative immobilization of the cervical spine was performed by a halo cast set on a corset of gypsum. After this, the patient underwent a thyroidectomy and, at the same time, a metallic plate was applied to immobilize C5-C7. A month after he underwent reoperative surgery to stabilize definitively the cervical spine. Subsequently he was treated by TCT and 131I subdivided in several cycles. The latest total body scan demonstrated a complete regression of secondary lesions.

Adenocarcinoma↗
PubMed1987

[Multicentric reticulohistiocytosis. A case with unusual clinical, radiologic and ultrastructural aspects].

We are reporting a case of multicentric reticulo-histiocytosis which is exceptional because of its gravity and the diversity of the clinical lesions: huge subcutaneous nodules, bone destruction in the spine responsible for spondylolisthesis, pulmonary fibrosis, acute pericarditis, laryngeal compression requiring a permanent tracheostomy. From ultrastructural observations, various hypotheses to explain the intra-macrophagic accumulation of membrane granules and lipids are discussed.

Arthritis↗
PubMed1987

Thoracic spine CT, diagnostic efficacy.

In 67 patients the diagnostic efficacy of thoracic spine CT was assessed. Diagnoses suspected clinically or by other examination methods could be confirmed by CT in 81% and excluded in 18% of cases. In one per cent (one case) the diagnosis, myelopathia vascularis, could not be seen by CT nor by myelography. In 49 cases the results of thoracic spine CT and myelography were compared with each other. CT gave additional information to myelography in 27% (13/49), but not in 73% (36/49). In 27% (18/67) of the whole material CT was able to replace myelography. It seems that CT is useless if myelography is normal, but CT may be useful in tumors, infections and medullary diseases. In traumas CT may replace myelography.

Female↗