Introductory Review
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Fall 1989
Volume 1, Number 1
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Abstracts
of this issue appear
below. Send e-mail or call 303-788-4010 to order a printed copy.
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 Abstracts
Colorado
Neurological Institute: A Regional Reference Center
Gary VanderArk, MD
The Colorado
Neurological Institute, established in 1988, grew out of
a medical community committed to excellence in the care
of neurological disease and disorders. Three hospitals -
Swedish Medical Center, Spalding Rehabilitation Hospital,
and Craig Hospital - along with more than 70
neuroscientists, all located on the same campus, have
formally combined their expertise in an organization
which provides patient care, research, and education in
the neurosciences.
Interventional
Neuroradiology: An Emerging Subspecialty
Richard Latchaw, MD
In the past
six years, there has been significant technological
improvement in the design of small flexible catheters,
guidewires, embolic material, releasable balloons,
visualization systems for delicate interventional
procedures, and computer processing for enhanced digital
angiography. These advancements allow the
neurointerventionalist to catheterize safely and
efficiently the blood supply to intracranial or
intraspinal arteriovenous malformations in order to
embolically occlude the vascular supply. Intracranial
aneurysms and arteriovenous fistulae may be successfully
treated with releasable balloons, sparing the parent
vessel. Tumors of the head, neck and spine may have their
vascular supply markedly reduced preoperatively in order
to facilitate resection. Interventional neuroradiology
has become a significant aid in the treatment of
neurological disease.
Percutaneous
Spinal Stimulation for Chronic Pain
Jay Law, MD
Chronic and
severe pain in the low back and leg which has persisted
or recurred after lumbar discectomy had not responded to
spinal stimulation during the 1970s. However, the
technical improvements which have been implemented by
stages during the past seven years have increased the
efficacy of this technique. We have reviewed our
experience during this time frame and reported the
improving clinical outcomes. The potential for combined
use of spinal stimulation and either more aggressive
surgical treatments or aggressive non-surgical therapies
is suggested.
Spinal Cord
Patient Care Costs as a Function of Injury Level
Robert Menter, MD, Gale Whiteneck, PhD, C.A. Brooks,
MSHA, Susan Charlifue, MA, Susan Solnick, ART
Craig Hospital
has specialized in the care, management, and
rehabilitation of spinal cord injuries for more than 30
years. The goal of the hospital’s rehabilitation
programs is to assist injured individuals in returning to
productive lives following disabling, life-changing
injuries. However, because spinal cord injuries are
complex, causing paraplegia and quadriplegia, and
affecting all body systems, the ultimate cost of the
lifelong process of recovery, rehabilitation, and ongoing
care is unknown. In an effort to estimate the lifetime
costs of spinal cord injury, Craig Hospital’s
research department conducted a cross-sectional follow-up
study of five patient groups in whom distinctly different
functional outcomes and costs would be expected.
Significant differences were found in follow-up expenses
by level of injury, and the study has prompted a national
research project of the National Spinal Cord Injury
Statistical Center at the University of Alabama in
Birmingham.
Multiple
Sclerosis Center Regional Research Update
Jack Burks, MD
Multiple
sclerosis is the most highly diagnosed neurologic disease
among adults between the ages of 20 and 50. Scientists
working to find the cause of MS theorize that the disease
is related to an exposure to a virus in childhood or
early adolescence among people who are genetically
susceptible. Demyelination is likely related to an
aberrant immune response. The Rocky Mountain Multiple
Sclerosis Center is the only comprehensive MS center in
the region and has treated 2,500 patients since it began
operation more than 10 years ago. At the MS Center, basic
scientists interact with clinical researchers and
clinicians to increase understanding of the MS disease
process and treatment efficacy. Patients have the
opportunity to participate in clinical research conducted
by the MS Center’s team of more than 30 healthcare
professionals. The MS Center also maintains a dedicated
rehabilitation unit, designed specifically for MS
patients.
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