We report our experience with sacroiliac joint arthrodesis in cases of overt osteoarthritis. Twenty-two operations were performed over a period of 3.5 years and reviewed between 12 and 55 months postoperatively. The clinical picture and diagnostic steps are discussed. We conclude that if the selection of patients is strict we can expect 70% satisfactory results.
This follow-up study analyzes the results of dorsal column stimulation instituted between 1972 and 1974 for the relief of pain in 84 patients, including 64 amputees. Good results decreased from 52.4% after 2 years of stimulation to 39% after 5 years. Special therapeutic problems in amputees are discussed.
Spinal cord stimulation seems today a promising method to improve spasticity. The experiences of two different clinics (Zürich and Freiburg i.Br.) are reported with long-term assessment up to 28 months. The objective data with measurement of stretch and H reflexes support the clinical results. An experimental study on animals does not permit a definitive explanation, but some hypotheses can be suggested.
Thresholds of non-painful and painful perception for electrical stimuli are not altered significantly during dorsal column stimulation either in the area of induced paresthesia or outside it. After long term stimulation of the dorsal column the thresholds for stimuli are significantly higher within the area of induced paresthesia but not outside it. Median nerve evoked somatosensory cortical potentials are not altered by conditioning or simultaneous DC stimulation. During DCS in three of eight patients only the vibration evoked cortical potentials were attenuated in the early three components of the potential.
Using transcutaneous nerve stimulation (TNS) simple surgical procedures such as tooth extractions and nerve biopsies can be performed without the usual anesthetics. Estimation of threshold and suprathreshold intensities of painful electrical stimuli show no significant change during TNS. Only the threshold for non-painful electrical stimuli is slightly increased. Cortical potentials evoked by electrical peripheral nerve stimulation are not significantly modulated by TNS. Latencies of the early components 0, I--III are unchanged, the amplitudes only slightly reduced. These observations are in contradiction to the 'gate-control' theory of pain.
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