Journal of neurosurgery
-
Journal of neurosurgery · Mar 2004
Comparative StudyBiomechanical evaluation of cervical lateral mass fixation: a comparison of the Roy-Camille and Magerl screw techniques.
The purpose of this study was to assess human cervical spine pullout force after lateral mass fixation involving two different techniques: the Roy-Camille and the Magerl techniques. Although such comparisons have been conducted previously, because of the heterogeneity of results and the importance of this procedure in clinical practice, it is essential to have data derived from a prospective and randomized biomechanical study involving a sufficient sample of human cervical spines. The authors also evaluated the influence of the sex, the vertebral level, the bone mineral density (BMD), the length of bone purchase, and the thickness of the anterior cortical purchase. ⋯ The difference between pullout forces associated with the Roy-Camille and the Magerl techniques was not as significant as has been previously suggested in the literature. It was interesting to note the influence of the vertebral level: Roy-Camille screws demonstrated greater pullout strength (23%) at the C34 vertebral level than Magerl screws but no significant difference between the techniques was observed at C5-6.
-
Vascular complications related to lumbar disc operations are rare but extremely fatal conditions. The authors analyzed data retrospectively obtained in 13 patients with vascular complications that occurred during lumbar disc operations performed between January 1990 and January 2002. ⋯ Despite its low incidence, iatrogenic vascular injury related to lumbar disc surgery is a possible complication. During lumbar disc operations early diagnosis of vascular injuries and urgent transperitoneal surgery can save patients' lives.
-
Journal of neurosurgery · Mar 2004
Surgical removal of corpus callosum infiltrated by low-grade glioma: functional outcome and oncological considerations.
Although still controversial, many authors currently advocate extensive resection in the treatment of low-grade gliomas (LGGs). Because these tumors usually migrate along white matter pathways, the corpus callosum is often invaded. Nevertheless, there is evidently no specific study featuring resection of the corpus callosum infiltrated by glioma, despite abundant literature concerning callosotomy in epilepsy surgery or transcallosal ventricular approaches. The aim of this paper was to analyze functional outcome following removal of corpus callosum invaded by LGG and to analyze the impact of this callosectomy on the quality of resection. ⋯ Resection of the corpus callosum infiltrated by glioma improves the quality of tumor removal without increasing the risk of sequelae.
-
Journal of neurosurgery · Mar 2004
Preoperative neuroimaging findings as a predictor of the surgical plane of cleavage: prospective study of 100 consecutive cases of intracranial meningioma.
To understand the cause and prevention of postoperative ischemic and/or venous parenchymal infarcts after intracranial meningioma resection, the authors describe the value of neuroimaging in predicting the surgical plane of cleavage. ⋯ Peritumoral edema on preoperative CT and MR studies and tumor pial vascularization as seen on selective angiography can be used to predict the surgical plane of cleavage in meningiomas. The association between tumor size and a subpial surgical plane may be explained by a more pial vascularization seen on angiography. Meningiomas with a location in eloquent cortex and a subpial dissection plane should be considered a high-risk group.