We reviewed the medical records of 45 paraplegic patients discharged with long leg calipers, during the 10 year period 1973 -82, from the Rehabilitation Hospital in Hornb�k, Denmark. A follow-up interview was carried out during 1993 -94 for all 40 patients who were still alive. Thirty had complete paraplegia (seven women) and 10 had incomplete paraplegia (two women). At the follow-up interview only three were still using their calipers. The main reasons for giving up the use of calipers was, in 38%, that it was too time consuming to put them on and take them off. For 22% the main reason was a fear of falling, while 19% reported that the calipers were impractical, as their hands had to be occupied in keeping balance and therefore could not be used for other purposes, including carrying items. The three paraplegic patients who did not totally give up the use of long leg calipers used them very little, at a maximum once a week. In contrast all 10 paraplegic patients who had been provided with a standing frame made use of this at least once a month. The majority of the remaining subjects were interested in having a standing frame. We therefore believe that a standing frame could be a good alternative to long leg calipers to facilitate standing for spinal cord injured patients.

The most important complications encountered by achondroplastic dwarfs are neurological problems related to a narrowed spinal canal. Stenosis of the spinal canal is secondary to abnormalities of endochondral ossification with premature synostosis of the ossification centres of the vertebral body and the posterior arch, resulting in thickening of the lamina, shortening of the pedicles, and reduced height of the vertebral bodies. Additional factors such as prolapsed intervertebral discs, osteophytes and progressive thoracolumbar kyphosis con tribute to the narrowing of the spinal canal.Three achondroplastic dwarfs having spinal stenosis and spinal cord lesion representing typical clinical courses are described.

Objectives: Cervical nerve root compression can lead to radiculopathy in the arm. Some studies have reported low accuracy in determining the responsible nerve root in both cervical and lumbar regions. This prospective, observational, pragmatic study aimed to determine the accuracy of the clinical evaluation relative to magnetic resonance imaging (MRI) findings in patients with arm radiculopathy.Methods: Patients with neck pain and neck-related arm pain referred to a spine unit underwent a standard clinical neurological examination and cervical spine MRI. The clinical examination required a judgment of the most likely cervical root involved, including the side. The Interobserver reproducibility was tested. Using MRI, the most likely nerve root involved according to radiology was assessed.Results: Eighty-three patients met the inclusion criteria. The Interobserver reproducibility between clinical evaluators was 58%, with a modest κ coefficient (0.33, 95% confidence interval [CI]: 0.18-0.47) classified only as "fair agreement."Only 31% (95% CI: 22-42) of the 83 patients exhibited full agreement regarding the suspected cervical root as assessed via the clinical evaluation and MRI. In another 28% (95% CI: 18-39), the clinical evaluation identified an adjacent level to that identified on MRI.Conclusions: In cervical radiculopathy, the clinical-neurological examination diagnosed the same in 31% or an adjacent cervical root in 28% of the patients in relation to the most affected cervical root on MRI.