Acta neurochirurgica
-
Acta neurochirurgica · Nov 2009
Herniated nucleus pulposus in isthmic spondylolisthesis: higher incidence of foraminal and extraforaminal types.
The purpose of this study was to evaluate the pattern of disc herniation and to investigate the associated symptoms in cases of isthmic spondylolisthesis. It is well known that the pathogenesis of degenerative spondylolisthesis associates with disc degeneration, followed by facet laxity and ligamentum flavum hypertrophy, which result in severe spinal canal stenosis. But isthmic spondylolisthesis is known to have a different pathogenesis. In isthmic spondylolisthesis, pseudodisc bulging is easily identified, and canal stenosis is comparatively rare. Therefore, we propose that isthmic spondylolisthesis has a different pattern of disc herniation from degenerative spondylolisthesis. We studied the type, incidence of disc herniation and clinical symptoms related to isthmic spondylolisthesis. ⋯ As expected, pseudodisc bulging without disc herniation was the most common type in isthmic spondylolisthesis. However, in cases of disc herniation, extreme lateral disc herniation occasionally occurs; therefore, every isthmic spondylolisthesis patient should be examined carefully for extreme lateral disc herniation with thin-cut axial CT or MRI, especially when the patients complain of lateralizing symptom.
-
Acta neurochirurgica · Nov 2009
Association of F18-fluoro-ethyl-tyrosin uptake and 5-aminolevulinic acid-induced fluorescence in gliomas.
Malignant gliomas are highly infiltrative tumours with a fatal prognosis. F18-fluoroethyl-tyrosine (FET)-positron emission tomography (PET) often reveals a broader extension of these tumours compared with contrast-enhanced magnetic resonance imaging (MRI). Complete resection of the contrast-enhancing lesion is aspired. Fluorescence-guided resection using 5-aminolevulinic acid (5-ALA) improved the extent of resection. In this study, we investigated whether the FET uptake correlates with the extent of resection using 5-ALA-induced fluorescence. ⋯ FET uptake predicts the 5-ALA-induced fluorescence in glioma patients. Thus, FET-PET provides useful information for planning glioma resection.
-
Acta neurochirurgica · Nov 2009
First experimental results with a new waterjet dissector: Erbejet 2.
Waterjet dissection represents a useful technique for many surgical procedures. In this experimental study, the technical features and dissection qualities of the new Erbejet 2 with its new pump and nozzle applicator system are evaluated for its neurosurgical use compared to the established Helix Hydro-Jet. ⋯ The new Erbejet 2 is more precise, with almost linear correlation of pressure and dissection depth compared to the Helix Hydro-Jet. Less foaming and the possible application of various separating media are a considerable advantage. All things considered, the new Erbejet 2 offers more options to enlarge the field of neurosurgical indications for waterjet dissection.
-
Acta neurochirurgica · Nov 2009
Minimally invasive dorsal percutaneous spondylodesis for the treatment of adult pyogenic spondylodiscitis.
Most adult patients with pyogenic lumbar or thoracic spondylodiscitis are treated with an external orthosis and antimicrobial therapy for several weeks to months. If surgical intervention is required, a combined anterior and posterior approach for debridement and fusion with autologous bone graft or titanium mesh cage is usually performed. ⋯ We conclude that minimally invasive percutaneous fixation is a feasible and effective technique to achieve immediate pain release, avoid long-term immobilization and overcome the disadvantages of a dorsoventral procedure. However, surgical complications and possible follow-up procedures supplement the patients' risks of adverse reactions of the disease.
-
Acta neurochirurgica · Nov 2009
Combination of bone marrow stromal cell transplantation with mobilization by granulocyte-colony stimulating factor promotes functional recovery after spinal cord transection.
Spinal cord injury (SCI) results in severe neurological deficit. However, the functional recovery following SCI is very poor due to the neural lost and limited axonal regeneration. To date, there was no effective treatment. Recent studies have shown that bone marrow stromal cells (BMSCs) transplantated into the central nervous system (CNS) can survive and differentiate into neuronal-like cells. Additionally, granulocyte colony-stimulating factor (G-CSF) can mobilize hematopoietic stem cells and inhibit neural cell apoptosis. Thus, we aimed to evaluate the combined effect of BMSC transplantation and G-CSF administration on rats with traverse spinal cord injury. ⋯ The animals with the combination treatment achieved a better functional and morphologic recovery, although partial. This synergistic effect between BMSCs and G-CSF may be attributed to extrinsic and endogenous neurogenesis in the traverse spinal cord injury.