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Understanding childhood cancer: Keys for the chiropractor
Journal of Manipulative and Physiological Therapeutics Volume 23 • Number 2 • February 2000 0161-4754/2000/512.00 + 0 76/31104073© 2000 JMPT
141
JOURNALABSTRACTS
Alto S, El MasryWS, Gerner HJ, Di Lorenzo Pellicano G, D'Andrea M, Fromm B, Freund M Ascending myelopathy in the early stage of spinal cord injury. Spinal Cord 1999;37:617-23.
ABSTRACT: A 30-year-old healthy woman was involved in a road traffic accident. She sustained a fracture dislocation of Tl 1/12 with a complete Frankel A paraplegia below T11. SI had no associated injuries. High Dose Methyl t nisolone was administered according to the NASCIS III protocol (48 h) together with low molecular weight Heparin and gastroprotected medication. Complete transection of the spinal cord and an anterior hematoma from T11 to T12 were confirmed on X rays, CT's and MRI scans. Posterior surgical stabilization was performed using Isola instrumentation, starting 8 h post injury. Her post surgical period was uneventful except for some episodes of low blood pressure (85/60 mmHg) from which she had no symptoms. On the 12th post operative day, while in the physiotherapy department, she complained of right scapular pain. This occurred every time she was sat up and was associated with paraesthesia of both upper limbs. Two days later she deteriorated neurologically and her level ascended initially to T8 and then to T3. MRI of the spine with and without gadolinium showed spinal cord oedema between C3 and T 1. There was no evidence of hemorrhage or syringomyelia. The authors discussed this case making different hypotheses. They are mainly the following: (1) Gradually ascending ischaemia due to a vascular disorder; (2) Double spinal trauma; (3) Ischaemia related to repeated hypotensive episodes; (4) Low grade intramedullary tumor; and (5) Thrombus of the Radicularis Magna artery. The case has been recognized as being very rare and interesting. In the conclusions, the presenting author stresses the importance of adopting MRI-compatible instrumentation for the surgical stabilization of the spine, and careful monitoring of blood pressure during the acute phase of spinal cord injury. Dr. Alto agrees with Mr. E1 Masry about the opportunity of forming a group of clinicians in order to discuss protocols to cope with this devastating complication.
es at the first metatarsal head for repair of halux abducto valgus deformity. However, most if not all of the radiographic and clinical findings associated with avascular necrosis at this level may also be explained by other processes. A critical review of avascular necrosis of the first metatarsal head is presented in conjunction with a discussion of al;rnative etiologies for the radiographic and ical findings that may be noted following capital osteotomies.
BarnesT. Understanding childhood cancer: Keys for the chiropractor. Top Clin Chiro 1999;6( l ):25-36.
ABSTRACT: Purpose: This article provides the chiropractor with a detailed review of childhood cancer. The five most common forms of pediatric oncology (leukemia, central nervous system tumor, bone cancer, neuroblastoma, and lymphoma) are highlighted with an emphasis placed on case presentation in a chiropractic office setting. Methodology: A literature search was conducted using Medline and published text sources. Summary: Many of the signs and symptoms of undiagnosed childhood cancer such as bone pain, neck stiffness, headache, and gait abnormalities are the same complaints that ,bring children into chiropractic offices for care. As primary care physicians, it is essential for chiropractors to stay alert for these red flags of pediatric cancer and to understand the need for rapid diagnosis of such conditions. Reprinted with permission from Barnes T. Understanding childhood cancer: keys for the chiropractor. Top Clin Chiro 1999;6:2536, © 1999 Aspen Publishers, Inc.
Campanacci M, Ruggieri P, Gasbarrini A, Ferraro A, Campanacci L. Osteoid osteoma. Direct visual identification and intralesional excision of the nidus with minimal removal of bone. J Bone Joint Surg(Br) 1999;81-B:814-20.
Banks AS.
ABSTRACT:
Avascular necrosis of the first metatarsal head. A different perspective. J Am Podiatr Med Assoc 1999;89:441-53.
We describe 100 consecutive patients with o s t e o i d o s t e o ma. Of the 97 who had operations, 89 w e r e treated by
ABSTRACT:
intralesional excision and eight by wide resection. The tlaree remaining patients were not operated on because the osteoid o s t e o m a w a s almost painless, or was found in the pecliele,of
Avascular necrosis of the first metatarsal head has been reported as a potential complication associated with osteoto-
141
JOURNALABSTRACTS
Alto S, El MasryWS, Gerner HJ, Di Lorenzo Pellicano G, D'Andrea M, Fromm B, Freund M Ascending myelopathy in the early stage of spinal cord injury. Spinal Cord 1999;37:617-23.
ABSTRACT: A 30-year-old healthy woman was involved in a road traffic accident. She sustained a fracture dislocation of Tl 1/12 with a complete Frankel A paraplegia below T11. SI had no associated injuries. High Dose Methyl t nisolone was administered according to the NASCIS III protocol (48 h) together with low molecular weight Heparin and gastroprotected medication. Complete transection of the spinal cord and an anterior hematoma from T11 to T12 were confirmed on X rays, CT's and MRI scans. Posterior surgical stabilization was performed using Isola instrumentation, starting 8 h post injury. Her post surgical period was uneventful except for some episodes of low blood pressure (85/60 mmHg) from which she had no symptoms. On the 12th post operative day, while in the physiotherapy department, she complained of right scapular pain. This occurred every time she was sat up and was associated with paraesthesia of both upper limbs. Two days later she deteriorated neurologically and her level ascended initially to T8 and then to T3. MRI of the spine with and without gadolinium showed spinal cord oedema between C3 and T 1. There was no evidence of hemorrhage or syringomyelia. The authors discussed this case making different hypotheses. They are mainly the following: (1) Gradually ascending ischaemia due to a vascular disorder; (2) Double spinal trauma; (3) Ischaemia related to repeated hypotensive episodes; (4) Low grade intramedullary tumor; and (5) Thrombus of the Radicularis Magna artery. The case has been recognized as being very rare and interesting. In the conclusions, the presenting author stresses the importance of adopting MRI-compatible instrumentation for the surgical stabilization of the spine, and careful monitoring of blood pressure during the acute phase of spinal cord injury. Dr. Alto agrees with Mr. E1 Masry about the opportunity of forming a group of clinicians in order to discuss protocols to cope with this devastating complication.
es at the first metatarsal head for repair of halux abducto valgus deformity. However, most if not all of the radiographic and clinical findings associated with avascular necrosis at this level may also be explained by other processes. A critical review of avascular necrosis of the first metatarsal head is presented in conjunction with a discussion of al;rnative etiologies for the radiographic and ical findings that may be noted following capital osteotomies.
BarnesT. Understanding childhood cancer: Keys for the chiropractor. Top Clin Chiro 1999;6( l ):25-36.
ABSTRACT: Purpose: This article provides the chiropractor with a detailed review of childhood cancer. The five most common forms of pediatric oncology (leukemia, central nervous system tumor, bone cancer, neuroblastoma, and lymphoma) are highlighted with an emphasis placed on case presentation in a chiropractic office setting. Methodology: A literature search was conducted using Medline and published text sources. Summary: Many of the signs and symptoms of undiagnosed childhood cancer such as bone pain, neck stiffness, headache, and gait abnormalities are the same complaints that ,bring children into chiropractic offices for care. As primary care physicians, it is essential for chiropractors to stay alert for these red flags of pediatric cancer and to understand the need for rapid diagnosis of such conditions. Reprinted with permission from Barnes T. Understanding childhood cancer: keys for the chiropractor. Top Clin Chiro 1999;6:2536, © 1999 Aspen Publishers, Inc.
Campanacci M, Ruggieri P, Gasbarrini A, Ferraro A, Campanacci L. Osteoid osteoma. Direct visual identification and intralesional excision of the nidus with minimal removal of bone. J Bone Joint Surg(Br) 1999;81-B:814-20.
Banks AS.
ABSTRACT:
Avascular necrosis of the first metatarsal head. A different perspective. J Am Podiatr Med Assoc 1999;89:441-53.
We describe 100 consecutive patients with o s t e o i d o s t e o ma. Of the 97 who had operations, 89 w e r e treated by
ABSTRACT:
intralesional excision and eight by wide resection. The tlaree remaining patients were not operated on because the osteoid o s t e o m a w a s almost painless, or was found in the pecliele,of
Avascular necrosis of the first metatarsal head has been reported as a potential complication associated with osteoto-