SummarySpinal epidural abscess (SEA) as a cause of back pain, fever, and neurological deficits has been recognised. Reports of this entity have increased in recent years, possibly likely secondary to increasing intravenous drug abuse. Most patients recover without neuro logical sequalae. Recent reports in fact indicate that those with persistent deficit have a much poorer prognosis for survival. As a result, few patients with SEA are seen in spinal injury rehabilitation programmes. Our 5 years experience with SEA was reviewed. Thir teen patients were admitted with residual neurological deficits following a course of pro longed antibiotic therapy. Of these most had progressive neurological improvement with only 3 of 4 remaining Frankel class A and 3 of 7 Frankel class C. The only mortalities (2) were secondary to the underlying medical problems. Most patients were discharged home.
SummaryFalls are the major cause of spinal cord injuries in older people. The pattern of injury seen most frequently is that of a central cord syndrome due to cervical hy perextension. The medical records of 58 patients over 50 years of age who sustained a spinal cord injury in a fall were reviewed for circumstances of onset, length of stay and outcomes of rehabilitation.The study identified elderly single or widowed men, and those who use alcohol, as high risk groups.
Delayed rehabilitation in postmeniscectomy patients may be due to a slowly resolving axonal compression syndrome secondary to the use of the pneumatic tourniquet. Twenty-five patients who underwent meniscectomy were examined to determine whether the pneumatic tourniquet used during the procedure caused a neurological dificit detectable by electromyography (EMG). Of these, 18 had postsurgical EMG changes that eventually resolved. Analysis of the data suggests a relationship between the occurrence of EMG abnormalities, the duration of the tourniquet inflation during surgery, and patient's recovery time. Quadricep muscle weakness after knee surgery has generally been attributed to disuse atrophy. In an attempt to prevent this problem, patients participate in a quadriceps exercise program, if possible, before surgery, with continuation after surgery. The persistence of weakness has been believed to be secondary to inadequate exercise.
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