Ventral discectomy with pmma interbody fusion for cervical disc disease: long-term results in 249 patients.

Study Design: Retrospective study of patients who underwent ventral discectomy and polymethyl-methacrylate (PMMA) interbody fusion for cervical radiculopathy.

Objectives: To evaluate the long-term outcome after ventral discectomy and PMMA interbody fusion and to compare it with previous data from other surgical techniques for the treatment of cervical radiculopathy.

Summary Of Background Data: Because PMMA interbody fusion after ventral discectomy does not result in solid bony fusion in all cases, a good long-term outcome using this surgical technique has been questioned.

Cavernous haemangiomas of the spinal cord. A review of 117 cases.

Intramedullary spinal cord cavernous haemangiomas are rare lesions that can cause severe myelopathic symptoms. The purpose of the present study was to define the pattern of clinical presentation, part of natural history, prognostic factors and therapeutic strategies considering both our own experience and reports from the literature. The data of 48 studies (published between 1903 and 1996), presenting information of all together 107 patients (108 lesions) regarding pre-treatment clinical and radiological factors, treatment strategies, and the outcome, plus our own experience of nine patients were retrospectively re-analyzed.

Dural cysts in the cervical region. Report of three cases and review of the literature.

Dural spinal cysts are exceedingly rare lesions. The authors are aware of only seven cases reported in the literature. This report comprises three patients with dural cysts of the cervical spinal canal who presented with atypical neurological signs and symptoms, including a long history of dysesthesias and atrophic pareses in the proximal upper extremities.

Spinal epidural cavernous hemangiomas. Report of three cases and review of the literature.

Epidural cavernous hemangiomas are increasingly identified as a cause of acute or chronic progressive spinal cord syndrome and local back pain or radiculopathy. The authors present three cases of spinal epidural cavernous hemangiomas manifesting as spinal cord syndrome, thoracic radiculopathy, and lumbar radiculopathy. Based on the imaging characteristics of these three cases and a review of the literature, the clinical signs and symptoms and their implications, the role of preoperative neuroradiological diagnosis, and the need for complete surgical resection are discussed.

Ganglioglioma of the spinal cord: report of two rare cases and review of the literature.

Objective And Importance: The goal of this article is to present the clinical and histopathological features of two rare cases of ganglioglioma occurring in the cervicothoracic and thoracolumbar spinal cord.

Clinical Presentation: A 4-year-old female patient presented with tetraparesis, whereas a 54-year-old woman showed paraparesis of both feet.

Intervention: Both tumors could be removed totally by microsurgical techniques.

The cross-sectional area of the cervical spinal canal in patients with cervical spondylotic myelopathy. Correlation of preoperative and postoperative area with clinical symptoms.

Study Design: Retrospective analysis of routine computed tomography investigations.

Objective: To investigate whether the extent of clinical symptoms in patients undergoing surgery for cervical spinal myelopathy depends on the transsectional area of the cervical spinal canal.

Methods: Forty-five patients underwent surgery using different techniques to enlarge the width of the spinal canal.

Imaging findings in patients with ventral dural defects and herniation of neural tissue.

The aim of this paper is to describe clinical and imaging findings in three patients with ventral dural defects and herniation of the spinal cord or cauda equina. The literature is reviewed and the clinical, radiological and operative findings are compared. Three patients with ventral dural defects of different etiologies are presented.

Spinal cord compression caused by the rod of a Harrington instrumentation device: a late complication in scoliosis surgery.

We report a unique complication caused by the rod of a Harrington instrumentation device, which resulted in spinal stenosis and myelopathy. A literature review revealed no previous causes of direct spinal cord impingement caused by the rod of a Harrington device. In this case, years after the initial operation, the rod penetrated the lamina at the junction between a thoracic and a lumbar curve, causing spinal stenosis and myelopathy.

Modification of costotransversectomy to approach ventrally located intraspinal lesions. Preliminary report.

To minimize tissue trauma and to reduce pulmonary complications a modification of costotransversectomy is presented. This procedure has been carried out in 6 patients with ventrally located space occupying lesions in the spinal canal. The results are good, complications did not occur.

T-laminoplasty--a surgical approach for cervical spondylotic myelopathy. Technical note.

The T-laminoplasty allows for a generous decompression of the cervical canal. At the same time, it avoids the risk of late instability. The T-laminoplasty is an improvement over various other methods of laminoplasty for several reasons: 1.

The treatment of spondylotic cervical myelopathy by ventral discectomy. Long term results on 121 patients.

The pathophysiology of spondylotic cervical myelopathy is still a matter of discussion. This paper presents a series of 126 patients operated on using a ventral approach. In 47% of the patients only a spondylotic narrowing of the spinal canal was present and in 35% an additional disc herniation was found.

Motor recovery following capsular stroke. Role of descending pathways from multiple motor areas.

The functional anatomy of motor recovery was studied by assessing motor function quantitatively in 23 patients following capsular or striatocapsular stroke. While selective basal ganglia lesions (caudate and/or putamen exclusively) did not affect voluntary movements of the extremities, lesions of the anterior (plus caudate/putamen) or posterior limb of the internal capsule led to an initially severe motor impairment followed by excellent recovery, hand function included. In contrast, lesions of the posterior limb of the internal capsule in combination with damage to lateral thalamus compromised motor outcome.

Three-dimensional MR reconstruction images of skull base tumors.

Forty-eight patients with skull base tumors were evaluated prospectively with T1-weighted spin-echo two-dimensional (2D) magnetic resonance (MR) sequences, a three-dimensional (3D) MR TurboFLASH (fast low-angle shot) sequence, and a 3D reconstruction window technique. All patients underwent surgery with histopathologic correlation, and the three MR imaging techniques were compared to assess representation of tumor margins and the topographic relationship of tumor to surrounding tissue and adjacent vasculature. The best results were obtained with standard 2D spin-echo sequences after administration of the paramagnetic contrast agent gadopentetate dimeglumine.

Surgical treatment and results in patients suffering from lumbar spinal stenoses.

Stenosis of the lumbar spinal canal is contributing to 3-5% of all patients operated on a lumbar nerve root compression syndrome. Morphologically, a reduction of the midsagittal diameter of the spinal canal to less than 12 mm or stenoses of the lateral recessus or foramen intervertebrale have been described. In our department 37 patients with a lumbar spinal stenosis have been surgically treated between 1982 and 1987.

[The proton MR spectroscopy of intracranial tumors. The differential diagnostic aspects for gliomas, metastases and meningiomas].

Twenty-two patients with intracranial tumours were examined by MR images and in vivo proton-MR-spectroscopy. The changes of relative concentrations of NAA, PCr/Cr, Cho, and Ins were measured spectroscopically and the amount of these metabolites were related to different tumour groups. Analysis of the results has shown that the spectra from all the tumours differed from normal spectra.

On the interpretation of proton NMR spectra from brain tumours in vivo and in vitro.

Localized proton NMR spectroscopy in vivo allows focal studies of cerebral metabolites in both man and laboratory animals from image-defined regions as small as 1 mL or 64 microL, respectively. Although brain tumours lead to remarkable spectral alterations relative to normal brain, a number of problems may compromise the interpretation of the results. Potential complications arise from the chosen experimental conditions (method, TE, size and location of volume of interest), from regional metabolic heterogeneity in and around tumours, from differences between human tumours and animal models, and from discrepancies between in vivo and in vitro findings.

The development of policy on denizens in Denmark.

"This article offers an analysis of Danish migration policy from 1960-90. The framework employed is the Swedish sociologist Thomas Hammar's concentric 'gate' model and his concept of 'denizens'. Non-Danish citizens' access to Danish society is regulated by 'gates' and security and rights increase in proportion with the number of 'gates' passed, culminating in naturalisation and full social, legal and political rights.

Management and prognosis of intracranial giant aneurysms. A report on 58 cases.

Between 1975 and 1989, 58 patients, 32 females and 26 males, mean age 50 years, with intracranial giant aneurysms with a diameter more than 2.5 cm were treated at our clinic. 48% of the patients presented with subarachnoidal hemorrhage.

Surgical observations in extremely lateral lumbar disc herniation.

About 10% of lumbar disc herniations are localized in an extreme lateral position referred to as "extracanalicular". The clinical syndrome is a typical one with compression signs of the lateral, extra-foraminal nerve root and minimal lumbar pain. A reliable diagnosis can be made only since high resolution spinal computed tomography has become available.

Neurosurgical management of cerebellar hemorrhage.

Controversy remains concerning the management of patients with cerebellar hemorrhage. In this study the records of 42 patients were reviewed. In 60% of them the signs of brainstem compression and upward transtentorial herniation were found.

Methods and applications of three-dimensional imaging in orthopedics.

Computed tomography is a commonly used technique for detecting pathological alterations in soft tissues and the skeleton. Three-dimensional images of the skeleton are very useful for planning surgical treatment and monitoring therapy, but unfortunately mental reconstruction of complex three-dimensional anatomical structures from conventional tomography is very difficult. This article describes a process by which automated analysis of the regions of interest in the computed tomographic (CT) images yields the contours of the surfaces which can be presented pseudo-three-dimensionally using Phong's lighting model and Gouraud's shading methods.