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Prolonged Headache Following Spinal Puncture

Response to Surgical Treatment

Barton A. Brown and O. W. Jones Jr.

, and unchanged symptoms of the back and lower extremity. An operation for his intervertebral disc disease was decided upon at this point because of the patient's failure to respond to conservative treatment and because of a mild myelographic defect. Operation . Bilateral L4, partial laminectomy and discectomy were carried out on February 4, 5 months after myelography. When the ligamentum flavum was reflected, a continuous flow of spinal fluid was seen seeping downward from above the area exposed. The epidural fat was edematous, indurated, and pale in color. (The

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Disease of Lumbar Discs

Ten Years of Surgical Treatment

Howard A. Brown and Manard E. Pont

patients are more likely to show improvement following operation on discs than patients in the industrial or compensation group. In 1944 Shinners and Hamby 8 reported that 59.5 per cent of the postoperative discectomy patients in the noncompensation group regarded themselves as cured, as opposed to 29 per cent in the compensation group. Raaf 7 reported a less striking contrast. Gurdijian et al. 4 reported that 76.6 per cent of the noncompensation group obtained excellent or good postoperative results as compared with 61.5 per cent of the compensation group

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Richard J. Otenasek and A. Earl Walker

of interrupted 3-0 or 4-0 silk subcutaneous sutures and tapes were applied to the skin. The margins of the skin or scalp were dried with a sponge before the application of the tapes. Routine dry surgical dressings were laid directly over the tapes. TABLE 1 Operative procedures Craniotomies 16 Craniectomies  Posterior fossa 5  Temporal 8 Trephinations 7 Laminectomies 6 Discectomies 4 Anterior cervical fusion 4 The incisions were inspected on the 3rd postoperative day

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Neal Aronson, David L. Filtzer and Merwyn Bagan

W e are presenting our personal experiences in treating cervical disc disease and spondylosis by the Smith-Robinson technique of discectomy and anterior cervical fusion. 5, 8 Based upon careful analysis of the results, it is our feeling that this operative method is superior to those commonly used for these conditions in the past. Modifications of the posterior approach have usually been used to treat various conditions of the cervical spine, depending upon the condition expected. One might treat a nerve root compressed by osteophytes by a foraminotomy; 7

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Beniamino Guidetti and Aldo Fortuna

fusion with calf bone (“Kiel bone splint”) in the anterior surgical approach for the treatment of myelopathies from cervical spondylosis. Acta neurochir. , 1969. (In press.) 11. Caron , J. P. , Rey , A. , and Houdart , R. A propos des discectomies cervicales par voie antérieure: Interprétation des résultats. Neuro-Chirurgie , 1966 , 12 : 608 – 613 . Caron , J. P., Rey , A., and Houdart , R. A propos des discectomies cervicales par voie antérieure: Interprétation des résultats. Neuro-Chirurgie , 1966, 12: 608

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Randall W. Smith and John D. Loeser

, 15, 16, 21 We have been unable to find reports of patients whose myelograms were free of radiological abnormalities yet who subsequently were found to have extensive arachnoiditis. We recently performed dorsal rhizotomies on three patients with intractable lumbar or sacral root pain following multiple lumbosacral fusions or discectomies. Preoperative myelograms demonstrated a variety of epidural defects consistent with recurrent herniated disc or epidural scar formation, but the subarachnoid contrast column failed to delineate the abnormalities that are commonly

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Dorsal column stimulation for control of pain

Preliminary report on 30 patients

Blaine S. Nashold Jr. and Harry Friedman

relief of back pain including laminectomies, fusions, discectomies, and in some cases, either open or percutaneous cordotomy. Often the pain had changed its original character from a severe radicular pain characteristic of nerve root involvement to a generalized burning pain involving the back and legs. All of the patients were receiving high doses of analgesics and in 13, narcotics were being used. Three patients had sustained brachial stretch injuries with root avulsion which was demonstrated by myelography in two; at operation for the placement of the DCS, the

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John D. Loeser

-term results, the difference was not statistically significant ( Table 5 ). Prior Surgery For purposes of this study, prior surgery for pain relief was defined as the performance of operation, alcohol block, or radiation therapy specifically aimed at the relief of pain. Initial discectomy for radicular signs was not considered as surgery for pain, but a second operation at the same level because of persistent or recurrent pain was considered a prior procedure for pain relief. Nine patients had had at least one operation prior to our dorsal rhizotomy; this group fared

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10.3171/jns.1972.37.1.0065 Anterior cervical discectomy without interbody bone graft Michael G. Murphy Mokhtar Gado July 1972 37 1 71 74 10.3171/jns.1972.37.1.0071 Lumbar disc syndrome Kenneth W. E. Paine Peter W. H. Haung July 1972 37 1 75 82 10.3171/jns.1972.37.1.0075 Intermittent cauda equina compression due to narrow spinal canal Hiroshi Yamada Masaki Ohya Tsuguo Okada Zenji Shiozawa July 1972 37 1 83 88 10.3171/jns.1972.37.1.0083 Neurogenic intermittent claudication associated with aortic steal

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Lyle E. Wacaser

F ollowing anterior cervical discectomy and fusion using bone from the patient's iliac crest, patients frequently complain more about pain in the hips than in the neck. A small variation in technique apparently avoid this complication. An skin incision paralleling the iliac is made as usual. The fascia is exposed, and a 2-in. incision is made starting at the crest and extending downward in the direction of the fibers. There is no transverse incision along the crest. When the leg is then adducted, the fascia relaxes sufficiently to permit stripping of muscle