To elucidate the etiology of postoperative spinal cord injury (PSCI) for patients undergoing laminectomy for fluorosis thoracic canal stenosis (FTCS) and summarize the methods of diagnosis and treatment.
From 2006 to 2009, a total of 192 FTCS cases underwent laminectomy. Among them, 16 cases with gradual postoperative neural deterioration were finally diagnosed as PSCI on MRI.One case of intraoperative spinal cord injury was excluded so that only 15 cases were included.
All cases were treated immediately with incision cite puncture and dehydration.Neural function recovered after secondary operation as JOA score improved from 3.00 ± 1.14 to 7.72 ± 1.41 at 12 months follow-up.Statistical analysis demonstrated a linear correlation between the diagnosis time and the improvement of JOA score.
Hematoma and fluid leakage are the common reasons of PSCI for FTCS patients. Meticulous hemostasis, usage of artificial dura matter and partial negative pressure drainage are valuable preventive measures.
An uncommon presentation of fluorosis
A 70 years old farmer from Yemen was referred as a case of osteoarthritis of both knees for preoperative rehabilitation procedures. Six years before he developed progressive skeletal stiffness. By 70 years he became dependent for ambulation and many other self-care activities. He showed quadriparesis resulting from compression of spinal cord
The therapeutic effect of acupuncture for treatment of joint pain of skeletal fluorosis
Objective: To observe the clinical therapeutic effect of acupuncture for joint pain of skeletal fluorosis. Methods: Ninety-six patients with skeletal fluorosis joint pain were randomly allocated to filiform needle group(33 cases), heat needle group (32 cases) and caltrate group(31 cases); the clinical therapeutic effects of three groups were measured by visual
Screening vs. individual detection of industrial fluorosis: a decision analysis model
In preventive medicine and occupational health, decision-makers face uncertainty, divergent opinions, and varying needs. In the Swiss aluminum industry, screening for industrial fluorosis illustrates how decision analysis and cost-effectiveness analysis can provide rational and explicit models of decision-making in such contexts. Data on fluoride-exposed potroom workers are used to compare
Clinical and pathogenetic features of chronic occupational intoxication with fluorine compounds in modern conditions
Multi-year follow-up of 358 workers of aluminum pot rooms, including 165 individuals suffering from fluorosis, has shown significant changes in the clinical picture of the chronic occupational fluorine intoxication, developed under modern conditions of production, at lower concentrations of fluorine compounds in the air of working area. In this connection,
Skeletal fluorosis and its neurological complications
Of 46 cases of skeletal fluorosis in Punjab, India, 21 had compression paraplegia, All the patients lived in a small area where drinking-water and soil had an extremely high (though variable) content of fluoride. The intoxication chiefly affected the skeleton, producing typical radiological features of diagnostic value. The teeth also showed
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Fluoride & Spinal Stenosis
Spinal stenosis is a narrowing of the spaces in the spine that results in pressure being placed on the spinal cord and/or nerve roots. Although stenosis can develop without symptoms, it may produce numbness, tingling, pain and difficulty in walking, as well as a heavy/tired feeling in the legs. It is estimated that 250,000 to 500,000 Americans currently have symptoms of spinal stenosis. Skeletal fluorosis is one cause of stenosis.
Skeletal Fluorosis: The Misdiagnosis Problem
It is a virtual certainty that there are individuals in the general population unknowingly suffering from some form of skeletal fluorosis as a result of a doctor's failure to consider fluoride as a cause of their symptoms. Proof that this is the case can be found in the following case reports of skeletal fluorosis written by doctors in the U.S. and other western countries. As can be seen, a consistent feature of these reports is that fluorosis patients--even those with crippling skeletal fluorosis--are misdiagnosed for years by multiple teams of doctors who routinely fail to consider fluoride as a possible cause of their disease.
Fluoride & Osteoarthritis
While the osteoarthritic effects that occurred from fluoride exposure were once considered to be limited to those with skeletal fluorosis, recent research shows that fluoride can cause osteoarthritis in the absence of traditionally defined fluorosis. Conventional methods used for detecting skeletal fluorosis, therefore, will fail to detect the full range of people suffering from fluoride-induced osteoarthritis.
As demonstrated by the studies below, skeletal fluorosis may produce adverse symptoms, including arthritic pains, clinical osteoarthritis, gastrointestinal disturbances, and bone fragility, before the classic bone change of fluorosis (i.e., osteosclerosis in the spine and pelvis) is detectable by x-ray. Relying on x-rays, therefore, to diagnosis skeletal fluorosis will invariably fail to protect those individuals who are suffering from the pre-skeletal phase of the disease. Moreover, some individuals with clinical skeletal fluorosis will not develop an increase in bone density, let alone osteosclerosis, of the spine. Thus, relying on unusual increases in spinal bone density will under-detect the rate of skeletal fluoride poisoning in a population.
Skeletal Fluorosis in the U.S.
Although there has been a notable absence of systematic studies on skeletal fluorosis in the U.S., the available evidence indicates that the consumption of artificially fluoridated water is likely to cause skeletal fluorosis and other forms of bone disease in people with kidney disease and other vulnerable populations.
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