Zentralblatt für Neurochirurgie
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Zentralbl. Neurochir. · Nov 2007
Comparative StudyCranioplasty for large skull defects with PMMA (Polymethylmethacrylate) or Tutoplast processed autogenic bone grafts.
Aim of the study was a comparison of cranioplasty using the Tutoplast technology for autogenic bone processing and conventional polymethylmethacrylate (PMMA) calvarial re- construction. ⋯ Cosmetic results were more satisfactory with Tutoplast processed autografts, and the operating time for unilateral surgery was shorter. Complication rates were similar. Resorption occurred in all children and adolescents, but was rare in adults. Thus, Tutoplast processed autogenic bone grafts can be a reasonable alternative to other methods of cranioplasty in adult patients with large craniotomy defects. Cranioplasty in children and adolescents remains an unsolved problem.
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Zentralbl. Neurochir. · Nov 2007
Morphometric studies of the ligamentum flavum: a correlative microanatomical and MRI study of the lumbar spine.
Foraminal degenerative lumbar stenosis is traditionally considered a result of bony narrowing due to osteophytic appositions on the superior articular process. Clinical experience reveals that significant additional compression of the neural structures is due to degenerative hypertrophy of the adjacent ligamentum flavum. Therefore, microanatomical and neuroradiological investigations were performed to determine the microtopography of this ligament, especially with respect to its lateral extension. ⋯ Measurements from mid-aged cadavers show the extent of the ligamentum flavum including its intra- and extraforaminal parts. Due to this anatomical situation a hypertrophic ligamentum flavum may contribute significantly to nerve root compression at the level of the lateral spinal recess. This has to be kept in mind during surgical decompression, which might be incomplete unless these hypertrophied parts are completely removed.