Zhurnal voprosy neĭrokhirurgii imeni N. N. Burdenko
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Zh Vopr Neirokhir Im N N Burdenko · Jan 2011
Review[Proton "radiosurgery" of cerebral arteriovenous malformations].
Arteriovenous malformations (AVM) are vascular lesions arising from impaired angiogenesis at the stage of transformation of primary embryonic arteriovenous anastomoses into capillaries. Commonly AVMs manifest with spontaneous hemorrhage. ⋯ In addition, stereotactic radiosurgery is used either as a component of complex management of large AVMs or pre-planned procedure combined with endovascular intervention, or as a second line therapeutic option in residual AVM after subtotal surgical resection. Comparing with photons protons due to their unique physical properties have advantages in spatial spread of dose thus allowing to significantly decrease integral dose to the surrounding brain tissue when treating large AVMs with complex shape proximal to critical structures.
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During recent decades many methods of spinal cord hypothermia (SCH) were developed. Nevertheless the problem of SCH in complex urgent care of patients with complicated spinal cord injuries remains unsolved as well as problems of tactics and techniques of hypothermia. ⋯ Own observations during the procedure were used as criteria for evaluation of effectiveness. Implementation of suggested technique is expected to increase quality of surgical treatment of patients with complicated spinal cord injury, to improve surgical outcomes and to decrease rate of disability.
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Zh Vopr Neirokhir Im N N Burdenko · Jan 2007
Review[Neurostimulation in patients with chronic neuropathic pain in the so-called failed back surgery syndrome (world and the author's experience)].
The failed back surgery syndrome (FBSS) is defined as protracted or recurrent pain, mainly in the lower back and/or legs, even after previous anatomically successful spinal surgery. Treatment of such patients commonly involves difficulties since neither medical therapy nor repeated back surgery does not result in adequate pain relief. Spinal cord stimulation (SCS) is a minimally invasive procedure that allows physicians and patients to define the effect of therapy just before permanent implantation. ⋯ Many patients told about fair therapeutic effects and the occurrence of mild side effects. Thus, SCS is an accessible alternative to traditional therapy. It is the treatment of choice in drug-resistant FBSS patients where recurrent neuropathic pin persists after surgery and analgesics are no longer effective.