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  • Title: [400 intraspinal space-narrowing processes--a clinical study].
    Author: Niebeling HG, Hohrein D.
    Journal: Zentralbl Neurochir; 1978; 39(3):241-52. PubMed ID: 749432.
    Abstract:
    Among 400 observations by the authors, 2 per cent were admitted without and another 22 per cent with slight neurological disturbances. An incomplete transverse lesion of the cord with paraplegia was found in 61.7 per cent, a complete paralysis in 14.3 per cent of the cases. Meningiomas and neurinomas were found in 60 per cent of the patients. The average age of the tumour patients was 43,8 years. Meningiomas and metastases show a tendency to occur in older age groups. The "Glioma Age" was around 25 years. The majority of the tumours were located at the level of the thoracic cord. When breaking down according to the kinds of tumours, a different picture is obtained: neurinomas are chiefly located in the region of the cervical medulla and the thoracolumbar region; gliomas are mainly found in the cervical part of the medulla up to the central thoracic cord. A dissociation of the cerebrospinal fluid was found in 90 per cent of the examinations; in 50 per cent of the patients it was above 200 mg%. Within a period of four weeks after the operation, the following results were obtained: 5 per cent free from complaints, improvement in 39 per cent, aggravation in 10 per cent and 46 per cent still uninfluenced. Meningiomas and neurinomas showed the highest degree of improvement. 24 per cent of the patients suffered from transitory rectovesical disturbances, 15 per cent from urinary tract infections, 12 per cent from decubitus, 9 per cent from wound healing disturbances and another 9 per cent from pneumonia. Meningitis was found in 2 per cent. Within four weeks post operationem, the death rate was 10.5 per cent, but this was in the phase before the introduction of microsurgery. On the accuracy of the diagnoses: in 18 per cent the neurological findings were in agreement with the diagnosis and in 49 per cent they showed differences of 1 to 3 segments; in 11 per cent no definite diagnosis could be made. In 46 per cent the native X-ray picture showed pathological changes. Myelography with positive contrast media showed positive findings in 97 per cent and 98 per cent of positive findings were obtained with myeloscintigraphy.
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