Zhurnal voprosy neĭrokhirurgii imeni N. N. Burdenko
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Zh Vopr Neirokhir Im N N Burdenko · Jan 2014
[The evidence-based neurointensive care: what's next?].
The work is devoted to the analysis of modern trends of process of cognition in neurointensive care. In particular, considered the emergence and development of the method of "evidence-based medicine" in the treatment of patients with diseases and injuries of the brain. ⋯ The authors propose to combine the "evidence" data and the "classical style" of treatment, which involves individual clinical judgment based on knowledge of the pathophysiology and pathomorphology, intelligent use of technology, retrospective analysis of the beneficial and adverse effects of certain methods, creation of a special data bank of "natural" course of events, the development of individual prognostic model. The authors believe that the use of standards is more appropriate during acute illness and trauma, and the classic style is better for chronic situation.
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Zh Vopr Neirokhir Im N N Burdenko · Jan 2014
Clinical Trial[Complex skull defects reconstruction with САD/САМ titanium and polyetheretherketone (PEEK) implants].
Predictable and stable functional and aesthetic result is the aim of priority for the neurosurgeon dealing with the reconstruction of large cranial bone defects and complex-formed skull defects involving cranio-orbital region. ⋯ САD/САМ titanium and PEEK implants application should allow for optimal reconstruction in the challenging patients with complex-formed and large skull bone defects providing predictable good functional and aesthetic result together with surgery morbidity and duration reduction. Computer-assisted preoperative planning should be undertaken for САD/САМ implants creation in the cases of posttraumatic defects combined with adjacent bone structures deformities and benign bone tumors of cranio-orbital region, thus enabling one-step reconstructive surgery resulted in essential symmetry attained.
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Zh Vopr Neirokhir Im N N Burdenko · Jan 2014
Comparative Study[A comparative analysis of the effectiveness and potential of endoscopic and microsurgical resection of disc herniations in the lumbosacral spine].
The issue of advantage of endoscopic treatment of spinal disc herniations is debatable. Throughout the development, endoscopic technologies have been compared to microsurgical methods. The two-year experience of applying endoscopic methods was analyzed. ⋯ It was noted that there were no significant instrumental limitations for using endoscopic techniques, while angled optics and excellent color rendition enable better visualization of the surgical wound structures and more efficient use of the approach space. Given that the technical characteristics and capabilities of this method are not inferior to those of the microsurgical technique, the former technology can be used instead of the standard technique for removing intervertebral disc herniations. Furthermore, the technical capabilities of the method allow performing wide decompression of the neural structures during surgery, which can be used to treat spinal stenoses.
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Zh Vopr Neirokhir Im N N Burdenko · Jan 2014
[Experience of surgical management of trigeminal schwannomas that simultaneously spread to the middle and posterior cranial fossae].
trigeminal schwannomas account for 0.07-0.36% of all intracranial tumors and 0.8-8% of all intracranial schwannomas. Different surgical approaches are used depending on the topographic anatomical variant of the tumor. Dumbbell-shaped tumors that spread both to the middle and posterior cranial fossae are the most challenging ones in terms of their resection. ⋯ LETEA is an effective approach that allows resection of tumors from the middle cranial fossa and the cavernous sinus. Combined with RSA, this approach can be used for two-stage resection of dumbbell-shaped trigeminal schwannomas.