Akira Konishi

Surgical results of Lumbar Spinal Disorder Manifesting Drop Foot

We conducted a retrospective study on the surgical results of 49 patients with lumbar spinal disorders manifesting drop foot, and assessed the factors influencing surgical outcome. All patients (26 men and 23 women, mean age 56 years) underwent operation between 1997 and 2001, and were followed for more than six months. Surgical results were evaluated according to the manual muscle test of tibialis anterior. The relationship between surgical results and some clinical factors were analyzed. In conclusion, age at surgery is not a significant factor influencing surgical results. Significant factors that determine surgical results are the duration of symptoms before surgery, grade of muscle weakness at surgery and presence of cauda equina syndrome. These results suggest that patients presenting with drop foot and progressive cauda equina syndrome require early surgical treatment.

MR imaging in Vertebral Body Fracture

We studied MR imaging to evaluate the prognosis in vertebral body fractures (54 vertebral bodies in 48 patients). In all cases, T1WI showed a low intensity, thoughout progress, and their progress could not be estimated. T2WI showed mixed low and high intensity areas in 47 vertebral bodies. The low intensity area showed low and very low zones. We assumed the very low intensity area tobe a fracture line, and the high intensity area surrounding the low intensity area to be edematous lesion caused by trauma. In many cases, there were no changes in between the T1WI and T2 fat suppression imagings, after the patients were cleared of their symptoms. But 5 out of 12 patients followed 6M, showed decreased intensity in T2WI in proportion to decrease in their symproms. The cases showed remaining vacuum cleft in the vertebral body, especially across the vertebral body, assumed instability, and vertebral collapse.