Kouji Kuranobu

Does increased signal intensity of the spinal cord on MR images due to cervical myelopathy predict prognosis

We examined whether or not high signal intensity change on magnetic resonance imaging of the spinal cord of patients with cervical myelopathy is related to the clinical symptoms and prognosis. Twenty-five patients with cervical myelopathy were treated by decompressive surgery which involved laminoplasty or decompressive anterior interbody fusion. The pathological conditions were cervical disc herniation (n = 8), ossification of the posterior longitudinal ligament in the cervical spine (n = 7), and cervical spondylotic myelopathy (n = 10). The spinal cord compression and the intramedullary signal intensity at the site of maximum compression were evaluated pre- and postoperatively using T1- and T2-weighted images. There was no significant relationship between spinal cord compressive change and clinical symptoms. Patients in whom the high signal change of the spinal cord on T2-weighted sequence recovered after decompressive surgery had better recovery from clinical symptoms, but a statistical significance was not found. We suggest that signal changes on T2-weighted images may reflect pathological changes but cannot be used to predict prognosis at present.

Lumbar disc degeneration and segmental instability: a comparison of magnetic resonance images and plain radiographs of patients with low back pain

We analyzed disc space height, angular displacement, tilting movement, and horizontal displacement in 109 patients with low back pain and/or sciatica, on plain radiographs of the lumbar spine. These parameters were compared with the grade of disc degeneration as evaluated by magnetic resonance imaging with the aim of studying lumbar segmental instability. Disc space height decreased in proportion to the grade of disc degeneration. Angular displacement was significantly less with severe disc degeneration, accompanied by a tendency to stabilization of the motion segment. Tilting movement and horizontal displacement. did not correlate with the grade of disc degeneration. Lumbar segmental instability was recognized at all levels even in individuals who appeared to be normal or to have mild disc degeneration. The incidence of lumbar segmental instability at the L3-4 level was significantly higher in patients with normal discs or mild disc degeneration. At the L4-5 and L5-S levels it did not differ between different grades of disc degeneration.

The incidence of fractures of the proximal femur and the distal radius in Tottori prefecture, Japan

SummaryWe report the incidence of proximal femur and distal radius fractures in Tottori prefecture, Japan. In 1986 and 1987, 573 proximal femoral fractures and 1576 distal radial fractures were registered in this district. The age- and sex-specific incidence rates of these two fractures are lower among Japanese than among European or North American whites, according to previous reports. Thus, it was concluded that the incidence rates of these two fractures are lower in Japanese than in Caucasians.