Acta neurochirurgica. Supplement
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Acta Neurochir. Suppl. · Jan 2011
O-arm guided balloon kyphoplasty: preliminary experience of 16 consecutive patients.
Balloon kyphoplasty is now widely used for the treatment of vertebral compression fractures. Excellent pain relief is achieved with cement injection, but the safety of the procedure relays on excellent radiological exposure. The balloon kyphoplasty technique is usually performed using one or two C-Arm devices to allow correct antero-posterior (AP) and lateral view throughout the surgical procedure. ⋯ We prospectively evaluate on 16 consecutive patients, the feasibility of the O-Arm guided kyphoplasty procedure with the original, usual tools, and we measured the fluoroscopy time and the X-ray exposure. We didn't experience any device related problem and demonstrated a significant reduction of X-ray exposure and time of fluoroscopy. We believe that using this new intraoperative system, the overall time of surgery and fluoroscopy could still be reduced in a near future.
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Acta Neurochir. Suppl. · Jan 2011
Isoflurane preconditioning affords functional neuroprotection in a murine model of intracerebral hemorrhage.
Exposure to isoflurane gas prior to neurological injury, known as anesthetic preconditioning, has been shown to provide neuroprotective benefits in animal models of ischemic stroke. Given the common mediators of cellular injury in ischemic and hemorrhagic stroke, we hypothesize that isoflurane preconditioning will provide neurological protection in intracerebral hemorrhage (ICH). ⋯ These results demonstrate the early functional neuroprotective effects of anesthetic preconditioning in ICH and suggest that methods of preconditioning that afford protection in ischemia may also provide protection in ICH.
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Acta Neurochir. Suppl. · Jan 2011
ReviewPeriduroscopy: general review of clinical features and development of operative models.
Myeloscopy is a useful approach for both diagnosis and treatment of back pain. However clinicians have underestimated its potential. From the nineties myeloscopy has been used only as a diagnostic tool, without any improvement of the technique. Racz's method is nowadays still used for the lysis of adherence by applying medical solutions without a direct vision inside the spinal channel. In 1998 we showed the limitations of Racz's approach, and in 1999 we developed a new technique, introducing a Fogarty balloon to remove the occlusions of the spinal canal and the resaflex for the lysis of adherence at low temperature (Raffaeli-Righetti technique). In this paper we report a general review of our experience with periduroscopy for the treatment of failed back surgery syndrome (FBSS) and spinal stenosis. ⋯ myeloscopy technique enlightens pain-triggering mechanisms otherwise unrevealed; it has specific therapeutic value, whereas on the diagnostic side it has not revealed relevant pathologies. Its effectiveness in FBSS patients is high, with the advantage of its relatively easy implementation, limited invasiveness and repeatability.
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The extradural space is currently investigated through fluoroscopy and ultrasound for surgical approach, whereas magnetic resonance imaging has been used to provide detailed information. The aim of the present paper is to describe the radiologic anatomy of the sacral canal through a review of its appearance in the different radiologic techniques. CT is able to visualise also the sacrum and the content of the sacral canal, triangular in shape in the transverse images, being able to establish the measurement of the transverse area of the dural sac and of the canal diameter. ⋯ The band-like structure on top is the sacrococcygeal ligament. The band-like structure at the bottom is the dorsal surface of the sacrum. The sacral hiatus corresponds to the hypoechoic region observed between the two hyperechoic band-like structures.
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Acta Neurochir. Suppl. · Jan 2011
ReviewComparison of different preclinical models of intracerebral hemorrhage.
Intracerebral hemorrhage (ICH) is the most devastating type of stroke. It is characterized by spontaneous bleeding in brain parenchyma and is associated with a high rate of morbidity and mortality. Presently, there is neither an effective therapy to increase survival after intracerebral hemorrhage nor a treatment to improve the quality of life for survivors. ⋯ The "balloon" method has also been used to mimic ICH for study. In this summary, we intend to provide a comparative overview of the technical methods, aspects, and pathologic findings of these types of ICH models. We will also focus on the similarities and differences among these rodent models, achievements in technical aspects of the ICH model, and discuss important aspects in selecting relevant models for study.