Nihon Seikeigeka Gakkai zasshi
-
Nippon Seikeigeka Gakkai Zasshi · Nov 1995
Comparative Study[Histological, magnetic resonance imaging, and discographic findings on cervical disc degeneration in cadaver spines: a comparative study].
A total of 210 cervical intervertebral discs were taken at autopsy from 36 cadavers, and underwent both magnetic resonance imaging (MRI) and discography to compare their diagnostic efficacies for investigating degenerative changes in the cervical spine. The age of the subjects had ranged from 43 to 92 years with an average of 68.1 years. Following the autopsy, MRI and discography were performed on the excised cervical spinal column, and the specimen was then prepared for histological examination. ⋯ There was a remarkably high incidence for false-positive posterior protrusion on the MRI, which should be kept in mind on reading the MRI. 3) In the comparison of the MRI with the discography, a certain positive correlation was found as for disc degeneration, but not in complete accordance. 4) There was a considerable difference in the patterns of degeneration and in posterior protrusion of the discs between the cervical spine and the lumbar spine. The posterior protrusion in the cervical disc was more likely related to horizontal fissure and hyalinization of the posterior annulus, while posterior protrusion in the lumbar disc was often related to reversed orientation of the bundles and myxomatous degeneration of the posterior annulus. This difference was attributed to the difference in the mechanical properties of the cervical and lumbar spines.
-
Nippon Seikeigeka Gakkai Zasshi · Jul 1995
[Effects of fibular malunion on contact area and stress distribution at the ankle with six simulated loading conditions].
A shortened, externally rotated malunion in the lateral malleolus following an ankle fracture-dislocation often causes post-traumatic degenerative arthrosis even without talar displacement (occult malunion). The purpose of this study was to examine the effect of malalignment of the fibula on stress distribution in the ankle joint using two grades of pressure sensitive film (super-low and low) as a transducer. The ankles of seven amputated lower legs were mounted in an MTS machine, then loaded in 6 different positions of 3 single leg stance positions at the neutral, abduction and adduction of the foot, and 3 simulated positions in the stance phase of walking. ⋯ There was no significant difference between the ankle with a shortened fibula only and that with an additional 20 degrees external rotation. The stress change in the fibular malalignment was concluded to be mainly due to the shortened fibula. It seems that the shortened lateral malleoli affect the ankle joint regardless of the talar shift and may induce degenerative arthrosis.
-
Nippon Seikeigeka Gakkai Zasshi · Oct 1994
[An anatomical study of the carpal tunnel for endoscopic carpal tunnel release].
An anatomical study of the carpal tunnel was performed to characterize the transverse carpal ligament, enabling improved endoscopic carpal tunnel release. One hundred wrist joints obtained from 50 cadavers were studied. The width of the transverse carpal ligament (TCL) was found to be narrower in females than in males, and there was no significant difference in the width of the ligament between the right and the left wrist joints. ⋯ The width of the TCL had a significant positive correlation with both its length (p < 0.01) and the thickness of its distal part (p < 0.01). Neither the distance between the distal edge of the TCL and the superficial palmar arch nor the distance between the radial edge of the pisiform bone and the ulnar artery at the distal edge of the TCL were significantly correlated with sex, laterality, or age. These results indicated that the width and thickness of the TCL and the ulnar artery can be predicted by calculating the length of the TCL percutaneously, thus enabling a safe and reliable endoscopic carpal tunnel release to be performed clinically without any complication.
-
Nippon Seikeigeka Gakkai Zasshi · Sep 1994
Clinical Trial[A radiographic study of the progression of ossification of the cervical posterior longitudinal ligament: the correlation between the ossification of the posterior longitudinal ligament and that of the anterior longitudinal ligament].
Progression of ossification of the posterior longitudinal ligament (OPLL) was evaluated in relation to that of ossification of the anterior longitudinal ligament (OALL). The subjects of this study were 68 patients with OPLL in the cervical spine. 47 of them underwent conservative treatment, and the remaining 21 underwent decompression surgery of the cervical spine (involving 11 cases of laminectomy and 10 of an enlargements of the spinal canal). All 68 patients were followed up for more than 5 years. ⋯ There was also evidence of progression of OALL in these patients, at each level of the cervical spine, with particularly advanced progression at the lower levels with a higher rate than in the conservative cases. These results indicate that the progressions of OPLL and OALL are closely correlated, and that the same precipitating factors may therefore be involved in both OPLL and OALL. A marked progression of the ossification after surgery suggested that local factors of the cervical spine played an important role in the progression.
-
Nippon Seikeigeka Gakkai Zasshi · Oct 1993
[Reconstruction for brachial injury by the accessory nerve--anatomy of the accessory nerve and its innervation of the trapezius--Japan].
At present reconstruction of not only elbow function, but also wrist and fingers function is possible for totally paralysed root avulsion type of brachial plexus injuries by means of multiple nerve transfers and free muscle transplantation. Although denervation of the trapezius muscle may be a problem, the accessory nerve is used as the donor nerve for reconstruction. Forty-seven cadaver dissections were performed to determine the innervation of the trapezius. ⋯ This study came to the conclusion that it was possible to use the accessory nerve as the donor nerve without paralysis of the upper part of the trapezius, if the accessory nerve was used at an adequate point. Since the course of the accessory nerve is similar to one of the cervical nerve in the posterior triangle of the neck, it is difficult to distinguish them. The layer of the course and the great auricular nerve at the posterior margin of the sternocleidomastoid are reference points of the accessory nerve and the cervical nerves.