Intervertebral disc replacement for cervical degenerative disease--clinical results and functional outcome at two years in patients implanted with the Bryan cervical disc prosthesis.

Background: This is a prospective study of patients with degenerative cervical disease who underwent ventral discectomy and disc replacement with the Bryan((R)) cervical disc prosthesis. The objective was to investigate clinical outcome at 2 years of patients implanted with the Bryan disc and to evaluate function of the implant itself.

Methods: Fifty-four consecutive patients with cervical disc herniation and/or spondylosis with preserved mobility in the affected spinal segments were enrolled.

Results and outcome of neurosurgical treatment for extradural metastases in the cervical spine.

Metastatic lesions are the most common spinal extradural tumours. Significant advances in their neurosurgical management have been made in the last two decades. This retrospective study was undertaken to summarise the long-term results of surgery and the outcome of patients with cervical spine metastases.

Long-term intrathecal infusion of drug combinations for chronic back and leg pain.

Continuous intrathecal infusion of analgesic drugs by implantable pumps is recognized as an established treatment option for patients with chronic pain resistant to oral or parenteral medication. Polyanalgesia, the simultaneous use of more than one intrathecal analgesic drug, is practiced relatively often, but there are only a few published clinical studies on intrathecal polyanalgesia for chronic nonmalignant pain. This pilot study represents a long-term evaluation of a treatment regimen consisting of intrathecal morphine admixed with bupivacaine, clonidine, or midazolam in patients with chronic nonmalignant back and leg pain due to degenerative lumbar spinal disease.

Secondary tumor formation after stereotactic biopsy for intracerebral metastatic disease.

Background: There are only a few published cases of iatrogenic tumor seeding and distant neoplastic growth along the path of the cannula after stereotactic biopsy.

Case Description: We report the case of a female patient with a solitary lung cancer metastasis in the left parietal brain lobe. The tumor was stereotactically biopsied and treated by radiosurgery.

Immune response induced by retrovirus-mediated HSV-tk/GCV pharmacogene therapy in patients with glioblastoma multiforme.

This study was conducted to investigate immunological components of somatic gene therapy for primary glioblastoma multiforme (GBM) in adults. It involved 13 patients treated by surgical resection of tumor with subsequent radiation therapy. Seven of them received additional herpes simplex virus thymidine kinase/ganciclovir (HSV-tk/GCV) gene therapy by direct intracerebral injection of retrovirus (RV) vector producing cells (VPC) during tumor surgery and subsequent systemic administration of GCV.

Outcome in Cloward anterior fusion for degenerative cervical spinal disease.

The Cloward ventral interbody fusion is often employed for treatment of cervical degenerative disease. The present study was aimed at evaluating results and complications in this classical type of autologous bone graft procedure in a cohort of patients with radiculopathy (RP) or myeloradiculopathy (MRP). Indications for and limitations of the technique were investigated by retrospective data analysis in a series of 106 patients (30 females and 76 males).

Transcranial Doppler sonography in adult hydrocephalic patients.

Transcranial Doppler sonography (TCD) is a noninvasive technique for measurement of cerebral blood flow velocity (CBFV) in the major arteries of the circle of Willis. Dynamic changes in the pulsatility index (PI) and the resistance index (RI), as calculated from TCD data, allow for an assessment of the forces acting on the terminal vasculature of the brain. The present study was designed to investigate a possible relationship between TCD parameters and intracranial pressure (ICP) changes in adult patients with hypertensive hydrocephalus.

First Light Measurements of Capella with the Low-Energy Transmission Grating Spectrometer aboard the Chandra X-Ray Observatory.

We present the first X-ray spectrum obtained by the Low-Energy Transmission Grating Spectrometer (LETGS) aboard the Chandra X-Ray Observatory. The spectrum is of Capella and covers a wavelength range of 5-175 Å (2.5-0.

Is it useful to measure supratentorial ICP in the presence of a posterior fossa lesion? Absence of transtentorial pressure gradients in an animal model.

Previous studies with animal models of supratentorial ICP elevation have demonstrated a pressure gradient between the supratentorial and the infratentorial compartments. The present study was designed to investigate the possible presence of such a gradient in the case of infratentorial ICP elevation. An inflatable infratentorial balloon catheter was implanted in seven domestic pigs.

Hardware failures in spinal cord stimulation for failed back surgery syndrome.

Spinal cord stimulation (SCS) is an efficient means for treatment of the postsurgical lumbar spine condition known as failed back surgery syndrome (FBSS). Although the devices and the implantation techniques are well established and the technology is sophisticated, there are some complications caused by hardware failures. This study was aimed at identifying the most frequent types of hardware failures and their causes in FBSS patients treated with SCS.

[Unusual intra-extracranial extension of meningioma of the lateral skull base].

Extracranial meningiomas are rare tumors of the lateral skull base. A 37-year-old woman presented with tinnitus und progressive hearing loss of her right ear. A painful mass lesion was also palpable in her mandibular angle.

Occipito-cervical fusion with the cervical Cotrel-Dubousset rod system.

Diseases and conditions which cause instability of the craniocervical junction and the adjacent upper cervical spine are relatively common and potentially life-threatening. Direct internal occipitocervical fusion (OCF) is a modern means of surgical treatment in such cases, and has some advantages over simple immobilization of the affected segments. The present study was designed to evaluate surgical handling, results, and complications with a recently developed instrumentation for OCF, the Cotrel-Dubousset rod-and-hook system (CD).

Anterior cervical fusion with the Orion locking plate system.

Study Design: This study was conducted to evaluate an anterior cervical fusion plate system, the Orion locking plate, regarding its surgical handling, hardware-related failures, and short-term and long-term results.

Objectives: A comprehensive evaluation of the implant in a broad range of patients with cervical spine diseases.

Summary Of Background Data: Locking plates are the most recent devices for achieving anterior cervical spinal fusion and offer considerable advantages such as faster and easier implantation and fewer implant-related failures than older plate systems.

Coronally oriented vertical fracture of the axis body: surgical treatment of a rare condition.

The neurosurgical management in a rare case of vertical axis fracture is presented along with discussion of the supposed pathogenetic mechanisms and the biomechanics underlying this type of cervical spine injury. Comprehensive neuroradiological investigation prior to surgery clearly demonstrated the dislocation of the anterior part of the axis body with concomitant C 2/C 3-disk injury. Therefore, the unstable fracture had to be managed by a one-time combined ventrodorsal approach using anterior C 2-C 3 locking plate fusion and C 2 bilateral dorsal transpedicular screw fixation.

Unusual explanation for the death of a car passenger.

After collision of a car with the left rearside against a steel mast the 19-year-old front seat passenger was found comatose on the seat. CT imaging showed a depression fracture parietal on the left with an intracerebral haemorrhage on the opposite side. The cause of the injury was unknown to the surgeons at the time of operation.

Dorsal spondylodesis of unstable thoracolumbar fractures by a far-lateral approach to the disc.

This paper describes a modified and less traumatic approach to the thoracolumbar spine and compares it with standard techniques for instrumented spinal fusion. Ten patients with unstable fractures of the thoracolumbar spine were included in the open prospective investigation, and were treated by a surgical technique consisting of a dorsolateral approach to the injured segment, filling the disk space and the fractured vertebra with autologous bone, and transpedicular fixation with an AO internal fixator. All patients were followed for 6 to 12 months after surgery by clinical tests and spinal X-rays.

Prognostic factors in malignant glioma: influence of the overexpression of oncogene and tumor-suppressor gene products on survival.

Despite the use of multimodal therapy, higher-grade glioma is still uniformly fatal in the adult population. There is a considerable difference between the length of survival in each given patient, even within the same tumor type and malignancy grade group, suggesting that there are factors that might differentially influence outcome. To identify such factors, 107 patients with anaplastic or malignant glioma were retrospectively investigated.

Epidural electrical stimulation of the motor cortex in patients with facial neuralgia.

Chronic facial neuralgias often do not respond sufficiently to standard treatment methods. Alternative modalities are needed for long-term reduction of pain in such cases. The present preliminary report describes two patients with trigeminal and glossopharyngeal neuralgia, respectively, treated with standard methods without obtaining satisfactory pain relief.

Continuous monitoring of the partial pressure of oxygen in cerebral venous blood.

Objective: Clinical oxygen monitoring in the injured brain is somewhat difficult. However, ischemia is one of the major factors responsible for secondary tissue damage after head injury or subarachnoid hemorrhage. Therefore, the aim of the present study was to investigate the value of continuously monitoring the partial pressure of oxygen in cerebral venous blood (PcvO2) during changes in intracranial pressure (ICP).

[Continuous measurement of jugular venous blood gas. A case of subarachnoid bleeding].

Introduction: Recently, a compact multisensor device 0.5 mm in diameter has become available with a miniaturised Clark electrode for measuring blood oxygen tension and two optical fibres for measuring CO2 tension, pH, and temperature (Paratrend 7, Biomedical Sensors, High Wycombe, UK). We used this new probe for continuous blood gas monitoring in the jugular bulb as an alternative to the commonly used fiberoptic spectrophotometric oximetric measurement of haemoglobin saturation.

[Cerebrovascular fiberoptic catheter oximetry in an intracranial pressure model in swine. New aspects of a clinical routine].

Unlabelled: The reliability of continuous fibreoptic oximetry in cerebral venous blood and its correlation with intracranial and cerebral perfusion pressures (pressure-volume curve) were examined in an experimental porcine study.

Methods: The pressure in the infratentorial compartment of 13 domestic pigs (18-24 kg) was gradually increased by inflating a Fogarty balloon catheter placed on the surface of the right cerebellar hemisphere and below the tentorium. Single volumes of 0.

[Thromboembolic complications in neurosurgical patients].

This study was aimed at the analysis of thromboembolic risk factors in a large and representative group of adult neurosurgical patients. Using an open retrospectively designed mode of evaluation, 3162 inpatients treated in 5 years were investigated. Thromboembolism was diagnosed clinically and confirmed be ultrasound and phlebographic tests.

Factors predicting pituitary adenoma invasiveness in acromegalic patients.

Forty-four adult acromegalic patients carrying growth hormone-producing pituitary macroadenomas were investigated with neuroradiological and endocrinological techniques. Plasma growth hormone and somatomedin-C levels were repeatedly measured before surgical removal of tumors and during the follow-up period. Twenty-five patients presented preoperatively with an invasive adenoma that involved the cavernous sinus (CS).