Motor evoked potentials in the post-surgical follow-up of cervical spondylotic myelopathy.

Eighteen patients (6 female, 12 male; average age 51 years, range 37-79) with clinical and radiological evidence (MRI) of cervical spondylotic myelopathy (CSM) were examined. The subjects were divided into two groups depending on whether radiology indicated single level (9 patients) or multilevel (9 patients) compression of the cervical cord. All of the patients underwent surgical decompression.

Usefulness of motor evoked potentials in compressive myelopathy.

Motor Evoked Potentials elicited by transcranial magnetic stimulation were recorded from 1 degree Dorsal Interosseus for the upper limbs and from Extensor Digitorum Brevis for the lower limbs in 42 subjects with compressive myelopathy (36 in the cervical region and 6 in the dorsal region), radiologically defined by Nuclear Magnetic Resonance (NMR) imaging, with no clinical and radiological signs of radiculopathy. Central motor conduction abnormalities in the cortex-C8 and cortex-L5 tract were compared with clinical signs of motor impairment and with NMR findings. The subjects with medullar hyperintensity of NMR signal at the compression site level, showed a central conduction time (C.

Lumbar stenosis surgery: "recalibrage" according to Senegas.

In the treatment of lumbar stenosis the method known as "recalibrage" proposed by Senegas is the most recent alternative to extended traditional laminectomy. Posterior decompression, which is obtained by removal of the cephalic half of the laminae, the yellow ligaments and the intraforaminal part of the facet joint, reduces the risk of postsurgical instability and makes it possible to proceed with fusion which is not just posterolateral. In cases where there is intersegmental instability we applied the Hartshill rectangle, proposed by Doce, stabilized to the residual laminar and associated with genous grafting.

Automated percutaneous lumbar diskectomy according to the Onik method: conclusive considerations.

The Onik method of automated percutaneous diskectomy in the treatment of the herniated lumbar disk offers undeniable advantages which we have already elaborated in our preliminary studies. Nevertheless, further experience with this technique has allowed us to pinpoint several aspects worthy of more attention: patient selection and long-term results. The patient selection procedure must follow Maroon and Onik's original protocol to the letter in order to single out those patients in whom contained disk herniation has caused actual sciatic pain and not merely low back pain.

Arthrography of the prosthesetized painful hip: the importance of imaging and functional testing.

Thirty-four patients with painful prosthesetized hips were submitted to arthrography in order to evaluate the correlation between pain and the anatomical situation between the implants and the host bone. By injecting a local anaesthetic together with the contrast medium it was possible to perform functional tests comprising passive movements of the hip and full weightbearing for at least 5 minutes in order to ascertain whether or not the pain persisted. This yielded different results varying from total relief to persistence, depending on the type of mobilisation demonstrated by arthrography.