Neurochirurgie
-
Anterior lumbar interbody fusion (ALIF) has gained popularity for the treatment of degenerative disease of the lumbar spine. In this report, we present our experience with the ALIF procedure for treatment of failed back surgery syndrome following lumbar discectomy in a noncontrolled retrospective cohort. ⋯ On the basis of our results, we found ALIF to be a safe and effective procedure for the treatment of failed back surgery syndrome.
-
The neurosurgical procedures currently available for the treatment of trigeminal neuralgia can induce trigeminal neuropathic pain. Severe forms of trigeminal neuropathic pain correspond to the classical facial anesthesia dolorosa, whose treatment is known to be very difficult. ⋯ Meanwhile, some authors have proposed directly stimulating the nerve branches concerned, such as the supraorbital nerve, or discussing indications for thalamic stimulation. In this chapter, only the cortical stimulation procedure will be developed.
-
Knowledge of the anatomy of the cranial nerves is mandatory for optimal radiological exploration and interpretation of the images in normal and pathological conditions. CT is the method of choice for the study of the skull base and its foramina. ⋯ The MRI sequences optimize contrast between nerves and surrounding structures (cerebrospinal fluid, fat, bone structures and vessels). This chapter discusses the radiological anatomy of the cranial nerves.
-
Stereotactic radiosurgery is an alternative to conventional surgery for the treatment of trigeminal neuralgia. To better define the safety of radiosurgery and optimal technical choices, we reviewed our patient records and the literature. A total of 334 patients presenting with trigeminal neuralgia were treated between December 1992 and September 2005. ⋯ The details of operative technique are turning out to have a major influence on the clinical results. In our experience, high-dose (80-90Gy) retrogasserian (7-8mm from the brainstem) GKS provides the patient with a better chance of long-term pain relief and a lower risk of trigeminal nerve functional disturbance. GKS applied to the cisternal anterior trigeminal nerve using high doses provided safe and effective treatment for trigeminal neuralgia over the long term.
-
Case Reports
[Medical and economic reflections on Restore and Itrel neurostimulation systems for neuropathic pain treatment].
In 2007, four patients where implanted with the Restore neurostimulation system for intractable chronic leg pain at the Poitiers Hospital. The potential for improving the patients' quality of life and medical-economic concerns motivated this choice for these highly selected patients. ⋯ All patients receiving implants declared that they were very satisfied with the quality of stimulation provided by Restore and noted a significant improvement in their quality of life. If this solution becomes advantageous from an economic point of view, clinical data should lend support to the utility of this technological innovation for patients who have hitherto been in treatment failure.