Background: Ulnar collateral ligament (UCL) injuries of the elbow are uncommon in the general population but prevalent in the athletic community, particularly among baseball players. Platelet-rich plasma (PRP) injection therapy has become a popular nonoperative adjuvant treatment for such injuries to help reduce recovery time and avoid surgery. Purpose/Hypothesis: To analyze patient outcomes by injury severity and identify injury types that responded most favorably and unfavorably to PRP treatment. It was hypothesized that PRP therapy would prove to be most beneficial in the treatment of lower-grade, partial UCL tears and less effective in the treatment of more severe, complete UCL tears. Study Design: Cohort study; Level of evidence, 3. Methods: A cohort of 50 patients with UCL injuries in their dominant elbow, diagnosed by MRI (magnetic resonance imaging) arthrogram, underwent PRP therapy in conjunction with an established rehabilitation program. UCL injuries were classified by MRI as low-grade partial tear (Type I), high-grade partial tear (Type II), complete tear (Type III), or tear in more than 1 location (Type IV). Results: In total, 24 of 39 (61.5%) Type I and II tears, 3 of 3 (100%) Type III tears, and 1 of 8 (12.5%) patients with Type IV tears responded to UCL PRP injection therapy and were able to return to play without surgery. Ten patients required subsequent UCL PRP injections, of which 3 (30%) were able to return to sport without surgery. Conclusion: PRP treatment for Types I and II UCL tears shows great promise when combined with physical therapy and a rehabilitation program. Type III UCL tears demonstrated a high rate of success, although with low cohort numbers. Type IV UCL tears did not appear to respond well to PRP injection therapy and often required surgical intervention or cessation of sport. Therefore, PRP treatment does not appear to be appropriate for patients with complete Type IV UCL tears but may enhance recovery and improve outcomes in throwing athletes with Types I, II, and III UCL injuries.

S Su um mm ma ar ry yLumbar spinal stenosis (LSS) is a narrowing of the spinal canal and/or the neuroforamina through which the spinal cord roots enter and exit. The symptoms of LSS usually begin over the course of several months and include neurogenic claudication. This is characterized by low back pain that radiates down one or both legs producing pain or weakness. LSS can be quite debilitating and can have a profound negative effect on one's activities of daily living and overall quality of life. Imaging studies, such as computed tomography (CT) and magnetic resonance imaging (MRI) are routinely performed in the work-up of suspected LSS. In recent years, there has been much controversy over the actual clinical usefulness of these studies. When compared to electrodiagnostic studies, CT and MRI have been shown to have increased false negative and false positive rates. Electrodiagnostic studies show dynamic physiological neural function and has become a valuable tool in LSS. This information can be used to determine the location and severity of LSS, differentiate LSS from other conditions, and monitor the progression. Electrodiagnostic techniques such as somatosensory evoked potentials, dermatomal somatosensory evoked potentials (DSEPs), and paraspinal mapping (PM) increase both the sensitivity and specificity in diagnosing LSS. DSEPs provide useful information on multi-level, multiple rootlet disease. PM reflects the physiology of nerve roots and has been found to be superior to extremity needle EMG. Electrodiagnostic techniques are becoming the standard in the diagnosis and therapeutic decisions for LSS and other related diseases.Turk J Phys Med Rehab 2010;56:75-80. K Ke ey y W Wo or rd ds s: : Lumbar spinal stenosis, electrodiagnosis, low back pain, lumbar radiculopathy, paraspinal mapping Ö Öz ze et t Spinal kanalda ya da sinir köklerinin geçti¤i nöral foramenlerde daralma lomber spinal stenoz (LSS) olarak adland›r›l›r. LSS yaflam kalitesini belirgin derecede etkileyip engellili¤e neden olabilir. LSS'nin belirtileri aylar içinde ortaya ç›kar. Nörojenik klodikasyon, tek ya da her iki alt ekstremiteye yay›lan bel a¤r›s› ve güçsüzlük LSS'nin semptomlar› aras›nda say›labilir. LSS düflünülen olgularda bilgisayarl› tomografi (BT) ve manyetik rezonans görüntüleme (MRG) gibi yöntemler rutin olarak kullan›lmaktad›r. Fakat bu tetkiklerin LSS tan›s›na katk›s› ile ilgili tart›flma-lar giderek artmaktad›r. Elektrodiagnostik çal›flmalarla karfl›laflt›r›ld›-¤›nda BT ve MRG'nin yalanc› negatif ve yalanc› pozitiflikleri daha fazlad›r. Nöral fonksiyonlar›n gerçek zamanl› durumunu ortaya koyan elektrodiagnostik incelemeler LSS'de oldukça yararl›d›r. Elektrodiagnoz ayr›ca, LSS'nin lokalizasyonu ve fliddeti konusunda bilgi verir; hastal›¤›n ay›r›c› tan›s›nda ve progresyonunun takibinde de yararl›d›r. Somatosensoriyel uyand›r›lm›fl potansiyeller, dermatomal somatosensoriyel uyand›r›lm›fl potansiyeller (DSEP) ve paraspinal haritalama (PH) gibi elektrodiagnostik teknikler LSS tan›s›nda duyarl›l›k ve özgüllü¤ü artt›rmak-tad›r. DSEP,...

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