Neurosurgical review
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Percutaneous endoscopic lumbar discectomy (PELD) is a new technique for the decompression of the lumbar disc space and removal of nucleus pulposus via a posterolateral approach. The technique was introduced in Germany by the authors in April 1987. The method is indicated in patients with nonsequestrated lumbar disc herniation with an intact dorsal longitudinal ligament. ⋯ The relief of symptoms as judged by the patients was between 70-100 percent in the majority of the cases. Three patients had to be reoperated at the same level and site, because of either persistent or recurrent sciatica. The performance in local anesthesia, the atraumatic extraspinal approach, the reduced time of hospitalization and postoperative morbidity as well as the reduced time of work incapability are the main advantages of this new method.
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Neurosurgical review · Jan 1993
Somato-sensory evoked potentials in root lesions and stenosis of the spinal canal (their diagnostic significance in clinical decision making).
The aim of the present study was to determine the significance of different SEP techniques and parameters in clinical evaluation of cases of lumbar and cervical root lesions and stenosis of the spinal canal. Using a qualitative rating scale, 92 cases were analyzed retrospectively whose primary diagnosis was questioned because of conflicting data from clinical, neuroradiological and neurophysiological testing. ⋯ Except for the time-consuming method of segmental stimulation, the demonstration of the functional deficit itself by SEP techniques in general was frequently disappointing. The contribution of the different SEP parameters to clinical decision making and the clinical consequences are briefly discussed.
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We report on 146 patients with spontaneous intracerebral hemorrhage treated in the period between 1984 and 1988. The aim of this retrospective study was to point out factors for operative respectively conservative treatment. Looking for etiology, age, unconsciousness, localization and extension of hematoma as well as bleeding into the ventricles our results showed that patients over 70 years of age and/or in coma III and IV (Brussels Coma Scale) have a bad prognosis as well as patients with intraventricular bleeding. Patients seem to benefit from operation if hematoma is located in the hemisphere or cerebellar and the extension ranges from 3 to 5 cm.
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Neurosurgical review · Jan 1992
Osteosynthesis of injuries and rheumatic or congenital instabilities of the upper cervical spine using double-threaded screws.
The surgical treatment of instabilities of the upper cervical spine, independent of their cause, requires the use of differentiated procedures if functional anatomy is to be largely restored. Successful procedures have been the diagonal screw fixation of the axis from the anterolateral aspect in case of acute fractures of the odontoid process, transpedicular screw osteosynthesis of C2 in hangman's fractures with bony instability, and the transarticular screw fixation of C 1/2 with interarcual fusion for atlantoaxial instabilities. Compared with conventional screws, the use of double-threaded screws which are almost totally imbedded in the vertebral body has the advantage of eliminating local irritation, reducing the risk of surgery, and simplifying the operative procedure itself.
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A retrospective analysis of 32 patients older than 16 years of age treated at Neurosurgical Department of Hacettepe University within the last 30 years (1959-1988) for cerebellar medulloblastoma was considered. The clinical features, treatment modalities and outcome are discussed. The survival rates for 5 and 10 years were 14% and 7% respectively. The results are compared with that of literature.