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Title: Spinal stenosis and disorders of the lumbar spine
Author: Porter, R. W.
Awarding Body: University of Edinburgh
Current Institution: University of Edinburgh
Date of Award: 2001
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This is a submission of 57 publications on the subject of "Spinal stenosis and disorders of the lumbar spine". It describes work personally carried out or personally supervised, between 1978 and 1997. 30 publications describe studies of spinal stenosis. The development of the vertebral canal is investigated from archaeological material, foetal collections and by the studies of volunteers. Intrauterine factors are identified which influence the canal's size and shape. Epidemiological studies are presented which have measured the canal in large numbers of volunteer adults and children, and patients with low back pain. The clinical significance of the vertebral canal size in various back pain syndromes is identified and described. The patho-physiological mechanism of neurogenic claudication is investigated, demonstrating by a series of clinical and laboratory studies, that multiple level stenosis in a developmentally small canal, causes venous congestion of the cauda equina. Laser Doppler studies show that as a result of this venous congestion, there is probably a failure of arterial vasodilatation in response to exercise, responsible for leg symptoms when walking. Papers describe the natural history of stenosis syndromes, and how calcitonin was introduced and investigated as a method of conservative management of neurogenic claudication. 27 parallel publications describe investigations of other lumbar spine disorders. Biomechanical and ergonomic studies show that hard work can be good for the spine. In prolapse of the lumbar intervertebral disc, laboratory studies demonstrate the importance of pre-existing degeneration and the formation of a free fragment. The mechanism of the clinical signs of disc protrusion, their repeatability and new signs are described. Spondylolisthesis is investigated. Studies examine back pain epidemiology, the differential diagnosis and classification of back pain, and spinal surgery and failed surgery. There is an appendix by title only, which records many of these studies in 7 text books and 19 contributory chapters.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (D.Sc.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available