Zhurnal voprosy neĭrokhirurgii imeni N. N. Burdenko
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Zh Vopr Neirokhir Im N N Burdenko · Jan 2012
[First experience of stereotactic radiation therapy for vestibular schwannoma using CyberKnife].
Currently stereotactic radiosurgery has become the treatment of choice in small vestibular schwannomas. This paper discusses our first experience of application of CyberKnife system for stereotactic irradiation of these tumors. From April 2009 till June 2011 we treated 62 patients (35 female and 27 male) with vestibular schwannomas. ⋯ However we observed stable tendency: larger initial volume of the tumor and presence of trigeminal nerve dysfunction before treatment were poor prognostic factors for trigeminal neuropathy. Stereotactic irradiation using CyberKnife system is effective and sufficiently safe technique for management of vestibular schwannoma. The paper demonstrates high rates of tumor stabilization, hearing preservation and minimal incidence of complications associated with trigeminal or facial nerve.
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Zh Vopr Neirokhir Im N N Burdenko · Jan 2012
[Simvastatin efficacy in vasospasm treatment in patients after aneurysm SAH].
Number of trials had previously demonstrated cerebroprotective effect of statin therapy in SAH patients. Aim of the current study was to assess effects of simvastatin on vasospasm in clinical practice. The study group comprised 35 patients admitted to Burdenko Neurosurgery Institute with aneurysmal SAH in 2007-2011. ⋯ Statin group showed significantly lower rates of vasospam progression--42.9% vs. 76.7% in control (chi2-test, p = 0.01). Our evidence corresponds with outcomes of international trials of statin application in SAH patients. As follows from our results and existing randomized and clinical trials data there is no strong evidence nowadays to recommend statin prescription in SAH patients.
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Zh Vopr Neirokhir Im N N Burdenko · Jan 2012
[Analysis of radiological criteria correlation and clinical manifestation of central lumbosacral spinal stenosis].
to assess the correlation analysis of radiologic criteria referred to central degenerative spinal stenosis and intensity of clinical manifestation. ⋯ analysis of our patients group demonstrated absence of correlation between intensity level of degenerative central spinal stenosis based on neurovisualization methods and intensity of its clinical manifestation. Pearson's coefficient of correlation and Spearmen rank correlation for variable which evaluates clinical signs (DDIL in %) and neurovisualization data (antero-posterior diameter of the spinal canal (mm), interfacet interval (mm), and cross-section area of the spinal canal (mm2)) are not significant to zero (p > 0.2).
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Zh Vopr Neirokhir Im N N Burdenko · Jan 2011
Clinical Trial[Management of facet pain syndrome in patients treated by microdiscectomy].
Aim of this study was to assess effectiveness of high-frequency denervation of facet joints in facet pain syndrome in patients who underwent microdiscectomy. The analyzed series included 42 patients treated by microdiscectomy 2 to 56 months before minimally invasive manipulation. ⋯ VAS score after 6-12 months changed from 7.6 to 3.2 and from 7.9 to 2.2 in control and mail groups, respectively. Conclusions are made about effectiveness of high-frequency denervation of facet joints in patients with failed back surgery syndrome in conditions of their careful selection for this procedure.
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Zh Vopr Neirokhir Im N N Burdenko · Jan 2011
[Radiofrequency denervation of intervertebral joints in management of facet pain syndrome].
Back pain is very widespread and represents a socially significant problem of modern health care. During lifetime 90% of population experiences 1 or more episodes of back pain. This study focuses on assessment of effectiveness of radiofrequency denervation of intervertebral joints in management of patients with low back pain caused by facet pain syndrome. ⋯ In 112 (80%) patients pain regressed. Clinical series was analyzed using the scale for assessment of severity of lumbosacral spinal degenerative disease developed in Burdenko Neurosurgical Institute (Moscow, Russia). The performed study confirmed effectiveness of the assessed technique which allowed including of radiofrequency denervation of intervertebral joints in the algorithm of management of patients with degenerative changes in the lumbosacral spine as the surgical method used in case of ineffectiveness of conservative treatment.