Tatsuro Inadome

Neurogenic thoracic outlet syndrome in whiplash injury

A prospective study of 110 patients was carried out to determine the pathogenic significance of trauma to the upper body in the development of neural compressive irritation at the thoracic outlet. Twenty-nine patients were reviewed as cervical strain injuries (N group), 25 patients as probable neurogenic thoracic outlet syndrome (NTOS) (PT group), 39 patients as definite NTOS (T group), and 17 patients as NTOS associated with cervical disc disease (CD-T group). The time lapse between accident and diagnosis and the duration of treatment were significantly longer in T patients or CD-T patients than those in the N group. Radiography of NTOS patients also showed a higher percentage of cervical spine-length/height ratio. Traumatic NTOS would suggest two types related to direct damage of scalene muscles that included some physical aspects of cervical disc disease. Pathogenesis provided a key to the resolution of more complex posttraumatic problems of whiplash injury.

Results of Intervertebral Spacer for Posterior Lumbar Interbody Fusion by Total Facetectomy

Seventy-two patients were treated with posterior lumbar interbody fusion (PLIF) by total facetectomy (TF), using intervertebral spacer (i. e. AW glassceramic, hydroxyapatite), for lumbar degenerative disorders. Patients were followed clinically and radiographically from four months to over two years. Fusion was achieved in 95.8% of the cases, and good clinical improvement was shown in the JOA score for most patients. Especially, spinal fusion by PLIF was useful in relieving low back pain. PLIF by TF provides wide decompression, prevents iliac pain caused by picked bone and offers spinal surgeons numerous advanteges for the treatment of lumbar diseases. Use of the intervertebral spacer also provides good support and good filling-up for bone graft.