Spine
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Case Reports
Localization of foreign bodies in the spinal canal by computer-assisted biplanar digitizer.
This study is a report of the use of a computer-assisted biplane digitizer to locate shotgun pellets within the spinal canal in an incompletely paralyzed patient. It was necessary to determine if one or more shotgun pellets were located within the spinal cord of the patient. Because of the profusion of pellets it was not possible to determine which, if any, of the pellets were in the spinal canal by routine roentgenograms. ⋯ This report presents the method for localizing foreign bodies and discusses the results of the procedure. It was concluded that the described method successfully located the position of pellets with respect to the spinal column and cord. This method may be useful for locating metallic fragments that have to be surgically removed in other patients sustaining spinal cord injury secondary to single missile wounds.
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Twenty patients with intractable, postoperative, recurrent low-back pain were treated with a sequential, epidural injection of morphine (8 mg) and methylprednisolone acetate (80 mg). Concomitantly administered, these drugs provided 50-100% pain relief lasting 6-24 months and elicited prolongations of mood elevation and morphine-induced side effects. Evidence from computed tomography and electromyography, however, indicated no amelioration of pre-existing pathologies.
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Sixty-eight medical, social, and occupational history variables were analyzed in a general population of 442 men and 478 women, aged 30, 40, 50, and 60 years to identify possible indicators for first-time experience and recurrence or persistence of low-back trouble (LBT) during a 1-year follow-up. Variables that in univariate analyses showed statistically significant indications for future LBT were subjected to stepwise logistic regression analyses. ⋯ For first-time experience of LBT, the indicators identified by the regression analyses were frequent pain in the top of the stomach, previous hospitalizations and operations, daily smoking, and a long distance from home to work. The result suggests that the population likely to experience future LBT does not enjoy good general health even prior to its first LBT episode, and this, in turn, may be due to greater psychosocial pressure.