Fifty-four consecutive patients were studied prospectively with magnetic resonance imaging before microdiscectomy, and the findings correlated with clinical symptoms before and after operation. A sequestrated fragment was found in 59% of cases, a subligamentous disc sequestration in 25% and a disc protrusion in 16%. The levels operated on were L4/5-36%, L5/S1-62.5%, and one at L3/4; 71% were laterally placed, 10% lay intraforaminal and 10% medial. The diameter of the protrusion was 4 mm to 13 mm for the craniocaudal extension, and 5 mm to 18 mm for the anteroposterior extension. No correlation could be found between a neurological deficit and the size of the prolapse. A positive correlation was present between the increasing degree of canal obstruction and the degree of disc degeneration determined by imaging for extrusions, subligamentous disc sequestrations and free sequestrations. Nerve root inflammation and enlargement was seen in 36% of the images, corresponding to an operative finding of 32%. Magnetic resonance imaging is a helpful pre-operative diagnostic investigation which shows structural changes in the disc and the correct localisation and size of the disc sequestration, but there was no correlation between the imaging findings and the clinical symptoms.
Our study shows no significant differences in the rate of major complications after utilization of a collagen-based VCD for femoral artery access site closure in patients with severe lower limb PAD compared to those without; however, complications in the PAD group tended to be more severe, with the need for surgical repair.
PTA is an ideal method for accomplishing recurrent fistula failure due to its cost effectiveness and minimally invasive procedure. Recurrent stenosis has been a major problem of PTA as also in equal measure with surgical intervention.
In case of complete symptom resolution, a nonobstructive diuretic half-time of ≤10 minutes on early DRG following stent removal suggests that further routine renographic follow-up is unnecessary. Patients with an equivocal early DRG (T between 10 and 20 minutes) require further scintigraphic follow-up, as they have a 42.1% chance of staying equivocal.
Einleitung:Das Glenohumeralgelenk ist das Gelenk mit dem größten Bewegungsspielraum des menschlichen Körpers. Die knöchernen Elemente Glenoid und Humeruskopf weisen ein Oberflächenverhältnis von 1:3,5-4 auf und sind nicht in der Lage eine Gelenkstabilität zu sichern. Die Stabilität des Schultergelenkes beruht daher in erster Linie auf Weichteilstrukturen, zum einen passiven Strukturen wie dem Labrum glenoidale, der Gelenkkapsel und den glenohumeralen Bändern und zum anderen dynamischen Stabilisatoren in Form der am Schultergelenk angreifenden Muskeln, insbesondere denjenigen der Rotatorenmanschette. Aus dem Gesagten wird verständlich, daß das Glenohumeralgelenk das luxationsanfälligste des gesamten Körpers ist. Mit Zunahme sportlicher Freizeitaktivitäten werden in steigendem Maße traumatische Schulterluxationen, Schulterinstabilitäten durch repetitive Mikrotraumen und Schulterbeschwerden bei Patienten mit allgemeiner konstitutioneller Gelenküberbeweglichkeit beobachtet. Zur Diagnosestellung sind in aller Regel die exakte Erhebung der Anamnese und die dezidierte klinische Untersuchung ausreichend. Die Erkennung von Begleitverletzungen und speziell die Therapieplanungkonservativ oder operativ -erfordert jedoch genaue Kenntnisse der pathologischen Anatomie. Im Rahmen der weiteren Diagnostik kommen hierzu Schichtbildverfahren wie das Computer-oder Kernspintomogramm mit oder ohne intraartikulärer Kontrastmittelapplikation zur Anwendung. Ziel der vorliegenden Studie war .die Evaluation der Wertigkeit unterschiedlicher Schichtbildverfahren in der Diagnostik von Schulterinstabilitäten.
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