Acta neurochirurgica
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Acta neurochirurgica · Jul 2012
Case ReportsSurgical treatment of poorly visualised and complex cerebrovascular lesions using pre-operative angiographic data as angiographic DynaCT datasets for frameless stereotactic navigation.
Digital subtraction angiography (DSA) is the "gold standard" for the imaging of cerebrovascular lesions, particularly cerebral aneurysms and arteriovenous malformations (AVMs). Current stereotactic navigation is based on computed tomography (CT) and magnetic resonance (MR) images, which-even despite the use of CT angiographic (CTA) or MR angiographic (MRA) sequences-may not reveal small lesions, and may not demonstrate all the different facets of complex lesions. ⋯ Pre-operative formal cerebral angiography as an angiographic DynaCT dataset can be used safely and effectively for intra-operative navigation and treatment of cerebrovascular lesions, in particular, micro-cerebral AVMs.
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Acta neurochirurgica · Jul 2012
Types and severity of operated supraclavicular brachial plexus injuries caused by traffic accidents.
Brachial plexus injuries occur in up to 5% of polytrauma cases involving motorcycle accidents and in approximately 4% of severe winter sports injuries. One of the criteria for a successful operative therapy is the type of lesion. Upper plexus palsy has the best prognosis, whereas lower plexus palsy is surgically untreatable. The aim of this study was to evaluate a group of patients with brachial plexus injury caused by traffic accidents, categorize the injuries according to type of accident, and look for correlations between type of palsy (injury) and specific accidents. ⋯ Study results indicate that the most common injury was an upper plexus palsy. It was characteristic of bicycle accidents, and significantly more common in car and motorcycle accidents. The results also indicate that it is important to consider the potential of a brachial plexus injury after serious traffic accidents and to examine both upper extremities in detail even if some motor function is preserved.
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Acta neurochirurgica · Jul 2012
Clinical outcome of instrumented fusion for the treatment of failed back surgery syndrome: a case series of 100 patients.
Failed back surgery syndrome is defined as persistent chronic low-back pain and/or leg pain lasting more than 1 year, despite of one or more surgical procedures. Instrumented spinal fusion has been offered by surgeons as a potential treatment to recover from pain and functional disability. Factors contributing to good outcome of instrumented spinal fusion have not been investigated extensively. This study evaluated the global perceived recovery and functional status of patients after instrumented fusion for the treatment of failed back surgery syndrome. ⋯ The present study showed disappointing outcome of instrumented fusion for the treatment of failed back surgery syndrome in terms of perceived recovery, functional disability and pain. Conservative management is probably more beneficial and, therefore, more selective and careful assessment should be done in order to prevent unnecessary surgery.
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Acta neurochirurgica · Jul 2012
The denticulate ligament: anatomical properties, functional and clinical significance.
It is widely believed that the main function of denticulate ligaments (DLs) is to stabilize the spinal cord within the vertebral canal. The aim of this study was to assess the anatomical and histological structure of the DLs and to document any regional differences. ⋯ DL histology and anatomy are strongly correlated with the function of this structure at different spinal levels. It is important to have accurate knowledge about DLs as these structures are relevant for clinical procedures that involve the spinal cord or craniovertebral junction.