Acta neurochirurgica
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Acta neurochirurgica · Feb 2009
Percutaneous vertebroplasty for the treatment of osteoporotic burst fractures.
Vertebroplasty is a minimally invasive surgical procedure which involves injecting polymethylmethacrylate into the compressed vertebral body. At present the indications include the treatment of osteoporotic compression fractures, vertebral myeloma, and metastases. The value of vertebroplasty in osteoporotic compression fracture has been discussed comprehensively. The surgical operation for burst fractures without neurological deficit remains controversial. Some authors have asserted that vertebroplasty is contraindicated in patients with burst fracture. However, we performed the procedure, after considering the patents general condition, to reduce surgical risks and the duration of immobilisation. The purpose of this study is to investigate clinical outcomes, kyphosis correction, wedge angle, and height restoration of thoraco-lumbar osteoporotic burst fractures treated by percutaneous vertebroplasty. ⋯ Although vertebroplasty has been considered as contraindicated in thoraco-lumbar burst fractures, we successfully used the procedure as a safe treatment in patients with osteoporotic burst fracture without neurologic deficit. This method could eliminate the need for and risks of major spinal surgery. We would like to offer it as a relatively safe and effective methods of management in thoraco-lumbar burst fractures.
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Acta neurochirurgica · Feb 2009
Surgical strategies for ruptured blister-like aneurysms arising from the internal carotid artery: a clinical analysis of 18 consecutive patients.
Ruptured blister-like aneurysms arising at non-branching sites of the internal carotid artery (BLICAA's) sometimes cause disaster during aneurysm repair because of their characteristic configurations. Our study was designed to establish the best surgical strategies for such aneurysms. ⋯ The surgeon should be ware of the high risk of premature rupture during dissection of BLICAA's. Wrapping with cellulose fabric (Bemsheet) and holding clipping technique could be chosen as the optimal surgical modality for prevention of rebleeding from these lesions.