Up to 30% of patients who have had lumbar surgery for herniated disk or for spondylolisthesis or spinal stenosis have unsatisfactory results [1 -4]. Postoperative symptoms are often quite similar to the preoperative pain and radicu lopathy, sometimes less intense but often more distressing than before surgery. Once it has been determined that the persistent and recurrent postoperative symptoms are not due to some form of musculoskeletal imbalance or strain, causes to be considered must include changes or compli cations directly related to the surgery or to failure of the surgery to correct the preoperative condition. Indeed, Finne- However, the latter finding is difficult to interpret; is it a recurrent HNP? Is it an extradural scar? Myelography is also generally unrevealing in cases of lateral bony stenosis.As experience with high-resolution CT scanning of the lumbar spine has been increasing, it is becoming apparent that this noninvasive and easily performed study can give considerably more information about the postoperative spine than any of the other current imaging methods.
Materials and MethodsAbout 750 patients with previous lumbar laminectomies had CT scanning within a 28 month period. Most of these were postopera tive failed-back syndrome patients, with persistent or recurrent radiculopathy after surgery. A small group of 1 5 patients was scanned within 2 weeks after surgery to evaluate the early appear ance of the postoperative spine. For the most part, these early postoperative patients were asymptomatic at the time.Contrast enhancement studies to attempt distinction between recurrent disk herniation and extradural scar were performed on
Three cases of esophagitis caused by oral medication are reported: 2 were the result of prolonged use of quinidine tablets (producing focal subacute inflammation mimicking carcinoma in one and stricture in the other) and one occurred soon after ingestion of liquid KCl. Previous reports have implicated KCl tablets ("slow KCl"), tetracycline and doxycycline capsules, and ferrous sulfate tablets. The factors predisposing to this uncommon complication of oral medication are discussed. In all reported cases caused by KCl tablets, left atrial enlargement was present as the result of mitral stenosis.
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