RESUMO
A prospective evaluation of patients with lumbar spinal stenosis undergoing operative treatment was performed using treadmill-bicycle functional testing as well as Oswestry and Visual Analog Pain scales for self-assessment. Thirty-two patients undergoing spinal stenosis decompression with and without a concomitant spinal fusion were prospectively evaluated, preoperatively and a minimum of 2 years postoperatively. Surgical treatment was demonstrated to produce significant improvement in walking ability, and to a lesser degree, in the ability to bicycle 2 years postoperatively. Improvement in patient function demonstrated on the Oswestry questionnaire correlated with decreased pain observed on the Visual Analog Pain scale. The treadmill-bicycle test appears to be a useful tool for the differential diagnosis of neurogenic claudication and may be used as an objective test of postoperative outcome.
Assuntos
Claudicação Intermitente/etiologia , Estenose Espinal/complicações , Estenose Espinal/cirurgia , Adulto , Idoso , Teste de Esforço , Feminino , Humanos , Claudicação Intermitente/fisiopatologia , Laminectomia , Masculino , Pessoa de Meia-Idade , Medição da Dor , Período Pós-Operatório , Estudos Prospectivos , Resultado do Tratamento , CaminhadaAssuntos
Doenças da Coluna Vertebral/cirurgia , Estenose Espinal/cirurgia , Tomada de Decisões , Humanos , Laminectomia , Laparoscopia , Imageamento por Ressonância Magnética , Procedimentos Cirúrgicos Minimamente Invasivos , Radiografia , Doenças da Coluna Vertebral/diagnóstico , Doenças da Coluna Vertebral/diagnóstico por imagem , Fusão Vertebral , Estenose Espinal/congênitoRESUMO
Risser's sign, a measure of the excursion of the iliac crest apophysis, has been used to estimate remaining skeletal growth. We used the Brush-Bolton Collection to correlate iliac crest excursion with other roentgenographic standards of skeletal age. Iliac crest excursion was measured using Risser's technique. We were able to determine mean chronologic and skeletal ages for each Risser stage for boys and girls. The state of maturation of the iliac crest apophysis, together with clinical observations of secondary sexual maturation, permit an accurate assessment of skeletal maturation without the need for wrist and hand roentgenograms.
Assuntos
Determinação da Idade pelo Esqueleto , Ílio/crescimento & desenvolvimento , Adolescente , Adulto , Envelhecimento/fisiologia , Osso e Ossos/diagnóstico por imagem , Criança , Feminino , Humanos , Estudos Longitudinais , Masculino , Maturidade SexualRESUMO
The question of which brainstem neuronal receptors can mediate cholinergic REM sleep induction was investigated by injecting the pure muscarinic agonist bethanechol via glass micropipettes in the pontine tegmentum of cats. The REM sleep enhancement was observed to be equally potent, equally dose-dependent and its appearance equally site-dependent as that previously observed with carbachol, a mixed muscarinic/nicotinic agonist. The results suggest that the pharmacological activation of muscarinic receptors in pontine neurons is sufficient to trigger REM sleep.