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1.  Metastatic spinal tumors. 
Western Journal of Medicine  1993;158(1):72-73.
PMCID: PMC1021953  PMID: 8470397
2.  Cervical spondylosis. An update. 
Western Journal of Medicine  1996;165(1-2):43-51.
Cervical spondylosis is caused by degenerative disc disease and usually produces intermittent neck pain in middle-aged and elderly patients. This pain usually responds to activity modification, neck immobilization, isometric exercises, and medication. Neurologic symptoms occur infrequently, usually in patients with congenital spinal stenosis. For these patients, magnetic resonance imaging is the preferred initial diagnostic study. Because involvement of neurologic structures on imaging studies may be asymptomatic, consultation with a neurologist is advised to rule out other neurologic diseases. In most cases of spondylotic radiculopathy, the results of conservative treatment are so favorable that surgical intervention is not considered unless pain persists or unless there is progressive neurologic deficit. If indicated, a surgical procedure may be done through the anterior or posterior cervical spine; results are gratifying, with long-term improvement in 70% to 80% of patients. Cervical spondylotic myelopathy is the most serious and disabling condition of this disease. Because many patients have nonprogressive minor impairment, neck immobilization is a reasonable treatment in patients presenting with minor neurologic findings or in whom an operation is contraindicated. This simple remedy will result in improvement in 30% to 50% of patients. Surgical intervention is indicated for patients presenting with severe or progressive neurologic deficits. Anterior cervical approaches are generally preferred, although there are still indications for laminectomy. Surgical results are modest, with good initial results expected in about 70% of patients. Functional outcome noticeably declines with long-term follow-up, which raises the question of whether, and how much, surgical treatment affects the natural course of the disease. Prospective randomized studies are needed to answer these questions.
PMCID: PMC1307540  PMID: 8855684
3.  Lumbar spinal stenosis. 
Western Journal of Medicine  1993;158(2):171-177.
Lumbar spinal stenosis, the results of congenital and degenerative constriction of the neural canal and foramina leading to lumbosacral nerve root or cauda equina compression, is a common cause of disability in middle-aged and elderly patients. Advanced neuroradiologic imaging techniques have improved our ability to localize the site of nerve root entrapment in patients presenting with neurogenic claudication or painful radiculopathy. Although conservative medical management may be successful initially, surgical decompression by wide laminectomy or an intralaminar approach should be done in patients with serious or progressive pain or neurologic dysfunction. Because the early diagnosis and treatment of lumbar spinal stenosis may prevent intractable pain and the permanent neurologic sequelae of chronic nerve root entrapment, all physicians should be aware of the different neurologic presentations and the treatment options for patients with spinal stenosis.
PMCID: PMC1021971  PMID: 8434469
4.  Improvement of photostress recovery testing after extracranial-intracranial bypass surgery. 
A patient with carotid occlusive disease experienced episodes of light-induced amaurosis in an eye with changes of venous stasis retinopathy. Though his macula appeared normal on examination, the macular photostress test (MPST) was prolonged. After anastomosis of a superficial temporal artery with the middle cerebral artery his symptoms resolved and his MPST returned to normal. The MPST may serve as a diagnostic stress test for the retinal circulation in cases of carotid disease.
PMCID: PMC1040996  PMID: 3964625

Results 1-4 (4)