Minimally invasive treatment of moderate lumbar spinal stenosis with the superion interspinous spacer.

Purpose: We evaluated the safety and effectiveness of the minimally invasive Superion(®) Interspinous Spacer (VertiFlex, Inc., San Clemente, CA) in patients with moderate LSS.

Methods: This single-arm prospective study enrolled 121 patients with moderate LSS between February 2008 and August 2009 and were followed up at 1 (n=111), 3 (n=96), 6 (n=81), and 12 (n=52) months.

Rationale, design and clinical performance of the Superion® Interspinous Spacer: a minimally invasive implant for treatment of lumbar spinal stenosis.

Lumbar spinal stenosis is a progressive degenerative condition that manifests as low back pain with neurogenic claudication as a cardinal clinical feature. Although mild radicular symptoms can often be successfully treated with conservative care, management of lumbar spinal stenosis grows increasingly difficult as symptoms worsen. No satisfactory nonsurgical treatments exist to manage moderate radicular symptoms and, therefore, these patients are faced with the decision of continuing ineffective conservative options or opting to undergo invasive decompressive spine surgery.

Percutaneous surgical treatment in lumbar spinal stenosis with Aperius-PercLID: indications, surgical technique and results.

Interspinous spacers have recently been used in the treatment of lumbar spinal stenosis. In vitro studies have demonstrated a reduction in facet joint forces by 68% and annulus pressures by 63%. MRI studies have demonstrated increased canal and neural foraminal area after implantation of these devices.

Percutaneous laser discectomy: experience and long term follow-up.

The classical microsurgical approach in the treatment of herniated nucleus pulposus (HNP) has been substituted over the years by endoscopical approach, in which it is possible to practice via endoscopy a laser thermo-discoplasty, and by percutaneous laser disc decompression and nucleotomy. Percutaneous laser disc decompression and nucleotomy have been performed worldwide in more than 40,000 cases of HNP. Because water is the major component of the intervertebral disc and in HNP pain is caused by disc protrusion pressing against the nerve root, a 980 nm Diode (Biolitec AG-Germany) laser introduced via a 21-G needle under X-ray or CT-scan guidance and local anesthesia, vaporizes a small amount of the nucleous pulposus shrinking the disc and relieving the pressure on the nerve root.

The role of provocative discography in minimally invasive selective endoscopic discectomy.

A discogenic etiology is being widely accepted as a primary source of chronic low-back pain. Even though increasing information is available on the pathophysiology of the degenerated disc, the present MR techniques are still not capable of pin-pointing the source of this pain. In other words, with a non-invasive MR1 study we can still not define which disc is painful and what are the characteristics of discogenic pain from an imaging perspective.

Involvement of spinal nerves in neurofibromatosis.

Spinal tumors are a frequent form of manifestation of neurofibromatosis. Out of 171 patients, who have been operated on over a ten years period on spinal tumors, 7 patients had neurofibromatosis (4.1%).

The lounging position for posterior fossa surgery: anesthesiological considerations regarding air embolism.

The sitting position for operations in the posterior fossa remains controversial in both adults and children, primarily because of the risk of air embolism. The reports on the incidence of this complication are varied. We retrospectively reviewed the data on 704 patients (age range 1-82 years) operated on in a lounging position for varied posterior fossa pathology from January 1984 up to December 1989.

Surgery of petroclival meningiomas: report of 24 cases.

Twenty-four patients with petroclival meningiomas were operated upon at the neurosurgical clinic of the City Hospital of Hannover between 1978 and 1987. Seventeen were women and seven men; the mean age was 45 years. Symptoms were usually present for more than 2 years before the diagnosis was made.

Revascularization of nerve grafts: an experimental study.

The time course of revascularization of grafted nerves, and the possible dependence of this revascularization on the length of the graft are two related questions that are addressed. Survival of Schwann cells in the nerve graft and a timely revascularization must be seen as a precondition for an optimal regeneration process. The revascularization process after different postoperative intervals is demonstrated in the sciatic nerve of rabbits by the use of microangiography, with Roentgen-positive water-soluble contrast medium.