Optimal duration of conservative treatment for lumbar disc herniation depending on the type of herniation.

Six hundred and six clinical records of patients who were admitted to the Department of Orthopaedic Surgery, Suwa Red Cross Hospital, Nagano, Japan, due to lumbar disc herniation (LDH) between 1991 and 2002 were reviewed to determine the ideal conservative treatment period in relation to different types of LDH: contained and non-contained. Since 1997, we have prolonged in-hospital conservative treatment over a few weeks, which resulted in a decrease in the number of surgeries for non-contained LDH, especially of surgeries performed within 1 month. The number of surgeries for contained LDH did not decrease.

Changes in total alkaline phosphatase level after hip fracture: comparison between femoral neck and trochanter fractures.

Background: Biochemical bone metabolic markers are affected by fractures, and total alkaline phosphatase (ALP) is considered one of the bone formation markers. Only a few reports have dealt with changes in bone formation markers during the healing process of bone fragility hip fractures. Despite the difference in the amount of callus formation and bone fusion rate, no significant differences in longitudinal change of total ALP between femoral neck and trochanter fracture have been reported.

Carpal tunnel syndrome and development of trigger digit.

Although the coexistence of carpal tunnel syndrome and trigger digit in the same hand is well documented, the interactive relationship between them is unclear. This study was conducted to examine the factors that may impact on the development of trigger digit in the hand with idiopathic carpal tunnel syndrome. One hundred and eighty-one patients were enrolled.

Snapping wrist after surgery for carpal tunnel syndrome and trigger digit: a case report.

We present a case of snapping dislocation of the flexor digitorum superficialis tendon to the small finger over the hook of the hamate that was noted after carpal tunnel release and trigger digit release.

Progressive symptomatic kyphotic deformity after decompressive surgery for lumbar destructive spondyloarthropathy.

Destructive spondyloarthropathy (DSA) is a serious complication of haemodialysis for end stage renal failure. We present a case of a patient who complained of back pain and cruralgia due to L2-3 disc degeneration with instability, and was treated with posterior decompression and bone grafting. Soon after surgery, the kyphotic deformity progressed and the symptoms deteriorated.

Ulnar nerve palsy at the elbow after surgical treatment for fractures of the olecranon.

Despite close proximity of the fracture site to the nerve, ulnar nerve palsy after surgery for fracture of the olecranon is uncommon. We examined 18 cases of fracture of the olecranon treated surgically retrospectively to see if there were any characteristics common to 4 cases of ulnar nerve palsy. Three cases of palsy with a comminuted fracture had fair or poor reduction as revealed by both the lateral and anteroposterior radiographs taken at the time of surgery.

Median nerve damage during two-portal endoscopic carpal tunnel release.

Objective: To evaluate the adverse effects of Chow's two-portal endoscopic carpal tunnel release (ECTR) performed by an experienced surgeon on median nerve function in patients with idiopathic carpal tunnel syndrome, as compared to open carpal tunnel release (OCTR).

Methods: Eighty-seven hands subjected to ECTR and 65 hands subjected to OCTR were reviewed. Both groups of patients were similar with regard to age, gender, and severity of the disease.

Abducens nerve palsy as a rare complication of spinal surgery: a case report.

We describe a case of diplopia due to abducens nerve palsy after upper cervical spinal surgery. A 22-year-old woman presented with a chief complaint of numbness and weakness in her left hand. A spinal cord tumor was detected at the C1/2 level.

Idiopathic spinal cord herniation associated with a large erosive bone defect: a case report and review of the literature.

We report a case of idiopathic spinal cord herniation associated with a large bone defect. MRI and computed tomographic myelography revealed ventral deviation of the spinal cord and erosion of the vertebral body at T6-T7. Microscopic surgery revealed a dural defect.

Microendoscopic discectomy (MED) for lumbar disc prolapse.

Microendoscopic discectomy (MED), which combines traditional lumbar microsurgical techniques with endoscopy, is being used as a minimally invasive procedure for lumbar disc herniation. We reviewed 30 patients who underwent MED at our institution and compared their outcome with that of patients subjected to the conventional method. Laboratory data suggested that MED was less invasive surgery.

The accuracy and safety of image-guidance system using intraoperative fluoroscopic images: an in vitro feasibility study.

The "virtual fluoroscopy" is a new navigation system that combines image-guided surgery and C-arm fluoroscopy. The purpose of this study was to evaluate the accuracy of this system in the case of pedicle screwing. The angular deviation in the axial and sagittal planes was measured using the bodies of 50 vertebral models.