Journal of neurosurgery
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Journal of neurosurgery · Jan 2004
Comparative StudyMitomycin C in preventing spinal epidural fibrosis in a laminectomy model in rats.
Extensive epidural fibrosis after lumbar surgery may be the underlying cause in most cases of failed-back surgery syndrome. Various materials have been used to prevent epidural fibrosis, but only moderate success has been shown. Mitomycin C, an alkylosing antibiotic substance isolated from Streptomyces caespitosus, potentially supresses fibroblast proliferation after surgery. In this study, the authors investigated the effect of mitomycin C by local application on spinal epidural fibrosis in a rat laminectomy model. ⋯ In this experimental model, mitomycin C applied locally at a concentration of 0.1 mg/ml effectively reduced epidural fibrosis, completely avoided dural adherence, and induced no side effects.
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Journal of neurosurgery · Jan 2004
Bladder function after incomplete spinal cord injury in mice: quantifiable outcomes associated with bladder function and efficiency of dehydroepiandrosterone as a therapeutic adjunct.
The authors conducted a study to establish outcomes associated with bladder function in a mouse model of spinal cord injury (SCI) and to assess the sensitivity of these outcomes in determining the efficacy of pharmacological treatments. ⋯ The authors found that early recovery of controlled voiding is predictive of motor recovery.
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Journal of neurosurgery · Jan 2004
Rotational and transpositional flaps for the treatment of spinal wound dehiscence and infections in patient populations with degenerative and oncological disease.
Wound-related complications following complex posterior spine procedures may result in the need for serial debridements and may place the instrumentation at risk. Numerous treatments have been advocated for this problem, but each has limitations. In this article the authors discuss the experience from two large teaching institutions at which rotational and transpositional flaps were used in the management of deep wound infections and dehiscences. ⋯ The use of local tissue flaps is advantageous for treatment of posterior wound complications due to spine surgery. In this procedure highly vascularized tissue is used to increase healing, accelerate clearance of bacteria, and fill any dead space.
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Journal of neurosurgery · Jan 2004
Case ReportsTraumatic aneurysm of the supraclinoid internal carotid artery and an associated carotid-cavernous fistula: vascular reconstruction performed using intravascular implantation of stents and coils. Case report.
This report documents the treatment of a traumatic aneurysm of the supraclinoid internal carotid artery (ICA) that was associated with a carotid-cavernous fistula (CCF), which appeared following closed head trauma. This life-threatening lesion, which is very rare, required aggressive management achieved using intravascular stents and coils. A 19-year-old man presented with severe traumatic intracerebral and subarachnoid hematoma after he had suffered a severe closed head injury in a motor vehicle accident. ⋯ Follow-up angiography obtained 7 months postoperatively revealed persistent obliteration of the aneurysm and CCF as well as patency of the parent artery. The patient remained asymptomatic during the clinical follow-up period of 14 months. Endovascular treatment involving the use of a stent combined with coils appears to be a feasible, minimally invasive option for treatment of this hard-to-treat lesion.
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Journal of neurosurgery · Jan 2004
Anterior correction of cervical kyphotic deformity: effects on myelopathy, neck pain, and sagittal alignment.
Cervical myelopathy may develop as a result of spinal cord compression with or without deformity. The effect of persistent kyphotic deformity on the ability of the cervical cord to recover following decompressive surgery is not known. ⋯ The correction of sagittal alignment may promote recovery in spinal cord function in patients with kyphotic deformity.