Surgical experience with an implanted artificial cervical joint

1998 ◽  
Vol 88 (6) ◽  
pp. 943-948 ◽  
Author(s):  
Brian H. Cummins ◽  
James T. Robertson ◽  
Steven S. Gill
Keyword(s):  
Stainless Steel ◽  
Medical Records ◽  
Extended Period ◽  
Cervical Radiculopathy ◽  
Joint Motion ◽  
Surgical Experience ◽  
Content Type ◽  
Steel Joints ◽  
Replacement Design ◽  
Fine Print

Object. To assess the effectiveness of Cummins' artificial cervical joint, the authors reviewed the cases of 20 patients in whom the joint had been placed. Methods. A review of patients' medical records and reexamination of 18 patients were performed. The review of the surgical experience with the implantation of movable stainless-steel joints in 20 patients treated for cervical myelopathy (16 patients), cervical radiculopathy (three patients), and severe pain (one patient) indicated that the procedure is safe and well tolerated and does preserve cervical joint motion in most patients over an extended period of observation. To date, adjacent segmental symptomatic degenerative changes leading to further surgical treatment have been avoided. The joint has been placed in patients with advanced congenital and acquired cervical fusion and has been demonstrated to be stable, mobile, and biomechanically and biochemically compatible; it has shown no subsidence into adjacent bone. Wear debris has not occurred. Conclusions. The use of stainless steel in the cervical spine appears to be suitable for this joint replacement design.

Astrocytomas of the spinal cord in children and adolescents

1985 ◽  
Vol 63 (5) ◽  
pp. 669-675 ◽  
Author(s):  
Ronald Reimer ◽  
Burton M. Onofrio
Keyword(s):  
Spinal Cord ◽  
Histological Grade ◽  
Extended Period ◽  
Spinal Deformities ◽  
Duration Of Symptoms ◽  
Female Ratio ◽  
Content Type ◽  
Orthopedic Procedure ◽  
Male To Female ◽  
Fine Print

✓ The authors review 32 cases of spinal cord astrocytoma in patients under 20 years of age who were treated at the Mayo Clinic between 1955 and 1980. There was a 1.3:1 male to female ratio. Twenty patients were between 6 and 15 years of age at the time of diagnosis. The duration of symptoms prior to definitive diagnosis varied from 5 days to 9 years, with an average of 24 months. The most common symptoms were pain (62.5%), gait disturbance (43.7%), numbness (18.8%), and sphincteric dysfunction (18.8%). The most common neurological findings were a Babinski response (50.0%), posterior column sensory dysfunction (40.6%), and paraparesis (37.5%). A median follow-up period of 8.6 years (range 0.8 to 25.5 years) revealed that the survival time diminished with increased histological grade of the astrocytoma (p < 0.001). The development of postlaminectomy spinal deformities represented a serious postoperative complication. This occurred in 13 patients and was first recognized between 8 and 90 months postoperatively. Six deformities occurred following cervical laminectomy, and eight patients required at least one orthopedic procedure. It is crucial to follow these patients for an extended period of time to watch for postoperative spinal deformities.

Surgical experience with chromophobe adenomas of the pituitary gland

1971 ◽  
Vol 34 (6) ◽  
pp. 726-729 ◽  
Author(s):  
Bronson S. Ray ◽  
Russell H. Patterson
Keyword(s):  
Radiation Therapy ◽  
Pituitary Gland ◽  
Operative Mortality ◽  
Postoperative Radiation ◽  
Surgical Experience ◽  
Postoperative Radiation Therapy ◽  
Content Type ◽  
Chromophobe Adenoma ◽  
First Time ◽  
Fine Print

✓ Between 1950 and 1969, 165 operations were performed on 146 patients for the treatment of chromophobe adenoma of the pituitary gland unassociated with either acromegaly or Cushing's syndrome. The over-all operative mortality was 1.2%, and no deaths occurred in 138 cases operated on for the first time. In 106 of the patients who had not received prior treatment, vision was improved in 80% of cases and returned to normal in 50%. In the group of patients whose initial treatment was surgery, postoperative radiation therapy was administered in one-half of the cases. The rate of recurrence was 8% in those who received radiation and 22% in those who did not. Recurrence of symptoms within less than 1 year often was due to a hemorrhagic cyst which could be treated better by reoperation than by radiation therapy.

Bipolar diathermy forceps with automatic irrigation

1985 ◽  
Vol 62 (6) ◽  
pp. 933-934 ◽  
Author(s):  
Tomio Ohta ◽  
Noboru Funatsu ◽  
Toshihiko Kuroiwa ◽  
Takayoshi Matsui
Keyword(s):  
Stainless Steel ◽  
Bipolar Diathermy ◽  
Content Type ◽  
Stainless Steel Tubing ◽  
Steel Tubing ◽  
Fine Print

✓ A method for providing a saline drip during bipolar diathermy is described. Stainless steel tubing is incorporated in both blades of standard bipolar forceps and connected to the irrigating line. Irrigation is started when the forceps are closed and is stopped when they are open.

Titanium miniplates or stainless steel wire for cranial fixation: a prospective randomized comparison

2002 ◽  
Vol 96 (2) ◽  
pp. 244-247 ◽  
Author(s):  
William C. Broaddus ◽  
Kathryn L. Holloway ◽  
Charles J. Winters ◽  
M. Ross Bullock ◽  
R. Scott Graham ◽  
...  
Keyword(s):  
Stainless Steel ◽  
Steel Wire ◽  
Stainless Steel Wire ◽  
Bone Flap ◽  
Content Type ◽  
Wire Fixation ◽  
Time Required ◽  
Titanium Miniplate ◽  
To Receive ◽  
Fine Print

Object. The authors designed a study to compare low-profile titanium miniplate fixation to that in which stainless steel wire is used. Methods. Before undergoing craniotomy, 40 patients gave informed consent and were randomized to receive either wire or miniplate fixation. After dural closure, bone flap fixation was timed. The bone flap was measured for inward or outward offset and mobility to manual pressure on its margin. Three months postoperatively the bone flap margins were graded for appearance or palpation of an offset and for the presence of burr hole depressions. Twenty-four patients were randomized to receive miniplate fixation and 16 to receive stainless steel wire fixation. The time required for wire fixation was approximately 40% longer than that for miniplates (11.8 ± 5.1 minutes compared with 8.3 ± 5 minutes, p = 0.02). The offset of bone flaps after wire fixation was significantly greater than that with miniplates (1.6 ± 1 mm compared with 0.3 ± 0.6 mm, p < 0.001), as was the mobility of the bone flap on digital pressure (1.2 ± 0.9 mm compared with 0.2 ± 0.5 mm, p < 0.001). At the 3-month follow-up review, two of 12 patients had suboptimal results after wire fixation, whereas none of 14 patients had suboptimal results after miniplate fixation. When dichotomized for excellent or less-than-excellent postoperative results, the data were significantly better for patients who underwent miniplate fixation (p < 0.05). Conclusions. Titanium miniplate cranial fixation provides more accurate and rigid reapproximation of the bone edges, with results that are significantly better on close inspection or palpation. The additional cost of miniplate fixation may thus be justified in many cases.

Cervical radiculopathy, entrapment neuropathy, and thoracic outlet syndrome: how to differentiate?

2004 ◽  
Vol 1 (2) ◽  
pp. 179-187 ◽  
Author(s):  
John E. McGillicuddy
Keyword(s):  
Older Patients ◽  
Thoracic Outlet Syndrome ◽  
Cervical Radiculopathy ◽  
Sensory Loss ◽  
Neuralgic Amyotrophy ◽  
Content Type ◽  
Arm Pain ◽  
Entrapment Neuropathies ◽  
The Common ◽  
Fine Print

✓ The common diagnoses of cervical radiculopathy and upper-extremity entrapment neuropathies can at times be difficult to differentiate. Additionally, thoracic outlet syndrome is often diagnosed when, in fact, the problem is radiculopathy or neuropathy. Another source of confusion, especially in older patients, is neuralgic amyotrophy, brachial plexitis, or the Parsonage—Turner syndrome. The differential diagnosis of unilateral arm pain, weakness, and/or sensory loss includes all of these problems. The clinical and electrodiagnostic features of each are discussed as an aid to distinguishing between these common and similar entities.

Multiple pituitary adenomas in Cushing's disease

2000 ◽  
Vol 93 (5) ◽  
pp. 753-761 ◽  
Author(s):  
John K. Ratliff ◽  
Edward H. Oldfield
Keyword(s):  
Cushing’S Disease ◽  
Medical Records ◽  
Pituitary Adenomas ◽  
Cushing's Disease ◽  
Clinical Database ◽  
Null Cell ◽  
Content Type ◽  
Initial Surgery ◽  
Repeated Surgery ◽  
Fine Print

Object. Clinically evident multiple pituitary adenomas rarely occur. The authors assess the incidence and clinical relevance of multiple adenomas in Cushing's disease.Methods. A prospective clinical database of 660 pituitary surgeries was analyzed to assess the incidence of multiple pituitary adenomas in Cushing's disease. Relevant radiographic scans, medical records, and histopathological reports were reviewed.Thirteen patients with at least two separate histopathologically confirmed pituitary adenomas were identified. Prolactinomas (nine patients) were the most common incidental tumors. Other incidental tumors included secretors of growth hormone ([GH], one patient) and GH and prolactin (two patients), and a null-cell tumor (one patient). In two patients, early repeated surgery was performed because the initial operation failed to correct hypercortisolism, in one instance because the tumor excised at the initial surgery was a prolactinoma, not an adrenocorticotropic hormone—secreting tumor. One patient had three distinct tumors.Conclusions. Multiple pituitary adenomas are rare, but may complicate management of patients with pituitary disease.

Pachymeningitis cervicalis hypertrophica

1987 ◽  
Vol 66 (1) ◽  
pp. 137-139 ◽  
Author(s):  
Jeffrey V. Rosenfeld ◽  
Andrew H. Kaye ◽  
Stephen Davis ◽  
Michael Gonzales
Keyword(s):  
Cervical Radiculopathy ◽  
Decompressive Surgery ◽  
Content Type ◽  
Neurological Improvement ◽  
Fine Print

✓ The authors present the case of a 25-year-old man with idiopathic pachymeningitis hypertrophica that caused cervical radiculopathy. Decompressive surgery produced significant neurological improvement. The etiology and management of the condition are discussed and the literature is reviewed.

The impact of minimally invasive cervical spine surgery

2004 ◽  
Vol 1 (1) ◽  
pp. 43-46 ◽  
Author(s):  
Tim E. Adamson
Keyword(s):  
Cervical Spine ◽  
Surgical Technique ◽  
Minimally Invasive ◽  
Cervical Radiculopathy ◽  
Foraminal Stenosis ◽  
Content Type ◽  
Cervical Spine Surgery ◽  
The Impact ◽  
Safe Treatment Option ◽  
Fine Print

✓ Since 1997, cervical endoscopic laminoforaminotomy (CELF) has been an effective and safe treatment option for unilateral cervical radiculopathy secondary to disc herniation or foraminal stenosis. The development of the surgical technique is reviewed and recent outcomes discussed. Its impact is addressed in relation to the patient and surgeon.

Self-irrigating bipolar diathermy forceps

1972 ◽  
Vol 37 (2) ◽  
pp. 246-247 ◽  
Author(s):  
Thomas T. King ◽  
Roy Worpole
Keyword(s):  
Stainless Steel ◽  
Bipolar Diathermy ◽  
Content Type ◽  
Stainless Steel Tubing ◽  
Steel Tubing ◽  
Fine Print

✓ A method for providing continuous saline drip in bipolar diathermy is described, which uses stainless steel tubing fixed to one blade of a standard bipolar forceps and connected to the irrigating line.

Brain tissue reaction to some chronically implanted metals

1970 ◽  
Vol 33 (5) ◽  
pp. 574-580 ◽  
Author(s):  
Anthony M. Dymond ◽  
Lloyd E. Kaechele ◽  
John M. Jurist ◽  
Paul H. Crandall
Keyword(s):  
Stainless Steel ◽  
Brain Tissue ◽  
Tissue Reaction ◽  
Molybdenum Alloy ◽  
Chromium Alloy ◽  
Content Type ◽  
Nickel Chromium ◽  
Platinized Platinum ◽  
Fine Print

✓ The toxicity of certain metals, namely, platinum, platinum-8% tungsten, platinum-10% rhodium, platinum-10% iridium, platinum-10% nickel, platinized platinum, a gold-nickel-chromium alloy, a gold-palladium-rhodium alloy, a chromium-nickel-molybdenum alloy (Vitallium), stainless steel, silver, rhenium, and gold, was evaluated histologically following chronic implantation for 2 months in the brains of cats. Of the above metals, all but silver were found to be nontoxic. Boron was also evaluated and found to be nontoxic.

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