Acta neurochirurgica. Supplement
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Acta Neurochir. Suppl. · Jan 1995
Comparative StudySpinal cord stimulation versus spinal infusion for low back and leg pain.
The relative roles of spinal cord stimulation and the spinal infusion of opioids in the treatment of chronic, non-cancer lower body pain remains unclear. This report contains a retrospective analysis of patients with chronic lower body, neuropathic pain and treated over a 5 year period. Unilateral leg and/or buttock pain was treated initially with spinal stimulation and bilateral leg or mainly low back pain was treated initially with spinal infusions. 26 patients received spinal stimulation. ⋯ The review indicates that spinal infusions may be best for bilateral or axial pain that has not responded to spinal stimulation. Clonidine appears to be an alternative in high-dose morphine patients. New diamond-shaped electrode and dual quadripolar arrays appear to be very helpful for back, buttock, and/or bilateral leg pain patterns.
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The results of endofiberscopic removal of traumatic intracranial haematomas and hygromas in 180 patients are analysed. Peculiarities of the surgical techniques using flexiscopes and original devices in epidural, subdural, intracerebral, intraventricular haemorrhages of various consistencies, size and location are reported. A technique of the trephination access and delayed cranioplasty for endoscopic removal of extensive subdural and intracerebral haematomas is presented. Indications, contra-indications for endoscopic haematoma surgery, advantages, disadvantages, failures of the techniques are discussed.