[Natural history and current surgical prognosis of intracranial arterial aneurysms].

The abrupt flow of blood in the meninges or in the brain after fissure or rupture of an arterial aneurysm still remains a medico-surgical emergency which includes the mobilisation of important technical and financial means which justifies itself by the reduction of the occurrence of a more severe accident and to give the patient its best chances. The cure of a cerebral aneurysm and its intracranial consequences must not be dissociated from its clinical context. Surgical indication must take into account the cause of the vascular lesion, the background on which it has evoked, its natural outcome which is characterised by rebleeding and vasospasm.

Percutaneous interbody osteosynthesis in the treatment of thoracolumbar traumatic or tumoural lesions. A review of 51 cases.

The authors describe a technique of percutaneous interbody osteosynthesis applicable to the dorsal and lumbar spine. 51 patients were so treated for different aetiologies: traumatic conditions (35 cases) and tumoural lesions (16 cases). The material used consisted of special instruments that are positioned in double obliquity by a percutaneous posterolateral approach.

Discectomies of the lower cervical spine using interbody biopolymer (B.O.P.) implants. Advantages in the treatment of complicated cervical arthrosis. A review of 150 cases.

The authors report their experience with 150 cases of discectomies performed with interbody grafts using a copolymer (Biocompatible Orthopedic Polymer or BOP). Made of N-Vinylpyrrolidone-Methylmethacrylate monomers, polyamide fibres and calcium gluconate. BOP is a biocompatible, biodegradable, osteoconductive matrix, easy to use and quite safe.

[Cervical melanotic neurofibroma. Apropos of a case and a review of the literature].

The authors report a case of cervical melanotic neurofibroma hour glass shaped, growing in the extra and intradural spaces. Melanotic aspect of spinal neurofibroma are rarely reported in the literature. Various etiopathologies have already been discussed.

[Percutaneous surgery of the dorsolumbar disks].

The authors report a new technique for percutaneous surgery of thoraco-lumbar discs. It allows nucleotomy or intersomatic grafting. This extra-articular posterolateral approach is performed under fluoroscopic monitoring by using a Kirschner's wire and some specific co-axial tubes.

[Direct osteosynthesis of fractures of the odontoid process using a biodegradable implant (B.O.P.)].

The authors describe a new technique for treatment fractures of the dens. An anterior approach (technique of Boehler) is used. It provides for one-stage fusion and no additional disturbance of C1-C2 rotation.

[Subacute extradural hematoma of the vertex. A case].

A patient suffers from a spasmodic triparesis 8 days after a cranial traumatism of the vertex. Ruptured superior sinus leads to development of an subacute extradural hematoma. The following course is uneventful after surgical cure.

[Surgical prognosis of unruptured intracranial arterial aneurysms. 50 cases].

The authors have reviewed a series of 53 patients with unruptured intracranial arterial aneurysm. Out of 50 patients operated upon, 2 died post-operatively, 5 remained with neural deficits that were present before surgery, and 43 were cured without subsequent cerebral or meningeal haemorrhage. None of the 3 unoperated patients developed cerebral vascular accidents.

Lateral gaze disturbance in a case of Wallenberg's syndrome.

A 63-year-old Caucasian man was admitted for Wallenberg's syndrome following a left vertebral artery thrombosis. In addition to the classical symptoms, an axial lateropulsion to the left and ocular motor disorders (vertical diplopia, tonic deviation of the gaze to the left, skew deviation and horizonto-rotatory nystagmus) were present. These clinical signs are unusual, but in common Wallenberg's syndrome, neurophysiological tests often reveal slight abnormalities of oculomotor function: impairment of jerks, skew deviation, lateral deviation of the gaze in darkness.

Chondroma of the cervical spine. Case report.

The authors report a case of cervical chondroma presenting with a syndrome of spinal cord compression in a 76-year-old woman. Total surgical removal of the lesion was followed by partial neurological recovery. Chondromas of the vertebral column are rarely reported in the literature.

[Treatment of chronic subdural hematoma in the adult by tapping and lavage (Aoki's method)].

In 1984, Aoki reported a new technique for treatment of chronic subdural hematomas in adults. This simple, effective technique and least invasive procedure lead us to use it. Our data seems encourageous as they were previously reported by Aoki.

[Osteosynthesis of the lower cervical spine using an anterior paediculo-isthmic screwed plate].

The authors report a new arthrodesis of the inferior cervical spine using a plate screwed into the pedicles by an anterior route. The procedure allows a complete and immediate stabilization of the cervical spine. Cervical orthosis is unnecessary in postoperative course.

[Reduction-stabilization of a vicious callus of the lower cervical spine by bilateral anterior approach].

The authors report a new technique which allows reduction and stabilization of cervical fractures healed in a vicious position. The procedure allows total removal of bony and discal protrusions, a correction of the pathological kyphosis by osteotomy of posterior facets. Advantages and drawbacks of this technique are discussed.

Surgical prognosis of unruptured intracranial arterial aneurysms. Report of 50 cases.

The authors analyze a series of 53 patients who presented with unruptured intracranial aneurysms. Fifty were operated upon, 2 died during the post-operative period, 5 were left with their pre-operative neurological deficit, 43 were cured and have not subsequently presented with any cerebral or meningeal haemorrhages. None of the 3 patients who were not operated upon has since presented with a cerebro-vascular accident.

Operative treatment of thoraco-lumbar metastases, using methylmetacrylate and Kempf's rods for vertebral replacement and stabilization. Report of 15 cases.

The authors report their experience in the treatment of 15 cases in thoracolumbar metastases with spinal cord compression. A decompressive laminectomy was routinely performed and followed by a transversoarthropediculectomy. Most part of the neoplastic tissue was removed from the epidural space, vertebral body and retroperitoneal or retro-pleural areas.

[Total ethmoidectomy by frontal and transmaxillary approach].

Four patients with cancer of ethmoid with extension to base of skull were treated by total ethmoidectomy through a subfrontal and transmaxillary approach, the complementary paralateronasal approach being necessary in only one case. Apart from the approach routes, particular features of the technique used were essentially the size of the frontal flap extending to orbital roof, and mainly the confection of a pericranial flap formed of epicranial aponeurosis lined with frontoparietal periosteum and pedunculated at the orbital border. Exposure of the tumor by the neurosurgical and sublabial transmaxillary route allows correct excision of cancers extending to cribriform plate.

[Approach to the anterior and lateral segments of the dorsolumbar spine by conservative transverso-arthro-pediculotomy].

The authors report a new technique of uni or bilateral transversoarthropediculotomy. It allows, according to the need, a conservative removal of a part or the whole posterior arch. This technique seems most suitable to avoid removal of posterior columns when a posterolateral approach is decided.

[Treatment of foraminal disk hernia by conservative hemi-transverso-arthro-pediculotomy].

The authors report a new approach of the intervertebral foramen using a conservative hemi-transverso-arthro-pediculotomy. It allows to remove one half of the posterior neural arch and to follow the nervous bundle from its origin to the extra-foraminal space. Removal of the foraminal disc herniation is easy and safe.

Bilateral posterolateral approach to the thoracolumbar spine through transversoarthropediculectomy with corporectomy.

Surgery of the dorsolumbar spine is currently benefiting from diverse approaches and the advent of computed tomography. This report describes a bilateral posterolateral approach with transversoarthropediculectomy and corporectomy. The advantages and disadvantages of this approach and its indications are discussed.

Herniated cervical discs. Analysis of a series of 230 cases.

Over a period of 18 years the authors have collected together 230 cases of herniation cervical discs. Multifactor analysis of the results of the various therapies is given. Surgical decompression has been done, mostly using an anterior approach, and it effectively treats the radicular damage; it stabilizes and improves spinal cord deficits whether the herniation is spontaneous or traumatic, acute or chronic.